Dr. Duran N. Yetkinler Profile

Dr. Duran N. Yetkinler

Director at ArthroCare Corp

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Proceedings Article | 17 June 2002 Paper

Novel radio-frequency technology (Coblation) for ear, nose, and throat surgery applications

Duran Yetkinler, Kelvin Lee, Lori Brandt, Ron Underwood

Proceedings Volume 4609, (2002) https://doi.org/10.1117/12.437917

KEYWORDS: Tissues, Plasma, Surgery, Electrodes, Ear, Nose, Throat, Wound healing, Temperature metrology, Natural surfaces

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Traditional radiofrequency devices use extreme heat (400-600 °C) to abruptly vaporize intracellular and extracellular fluids, causing tissue desiccation. On a new front, Coblation presents a unique method of delivering radiofrequency energy for soft tissue removal applications in medicine, including ENT surgery. Coblation involves energizing the ions in conductive fluid (saline), via a bipolar wand, to form a plasma field. The plasma has enough energy to break the tissue’s molecular bonds, creating an ablative path while resulting in minimal thermal penetration (70-90 °C) into surrounding tissue. Epithelial destruction, collateral tissue damage, and wound healing were observed in a rat tongue model. Coblation treated animals had significantly less epithelial destruction and collateral tissue damage, which resulted in less granulation tissue and faster wound healing. Clinical experience with coblation in otolaryngology has been very promising in a variety of situations. Specifically, coblation has been used for tonsillar surgery for total tonsillar excision, subtotal ablation and tonsil channeling with subsequent volume reduction . Clinical studies have shown that coblation has offered significant advantages compared to tradition techniques in each of these applications. In many cases patients operated on using coblation had a reduction of pain and a more rapid return to normal diet and activity. The blend of effective tissue ablation and hemostasis for bleeding that coblation offers may make it useful for most procedures that utilize electrocautery devices at this time.

Proceedings Article | 17 June 2002 Paper

Novel radio-frequency technology (Coblation) for dermatologic surgery applications

Duran Yetkinler, Andre Bessette, Jean Woloszko

Proceedings Volume 4609, (2002) https://doi.org/10.1117/12.437297

KEYWORDS: Tissues, Skin, Plasma, Electrodes, Collagen, Gas lasers, Injuries, Surgery, Laser ablation, Carbon monoxide

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Laser energy has been shown to be effective in skin resurfacing and other dermatologic surgery procedures, but it operates at relatively high temperatures (200-600°C). Lasers produce mid-to far-infrared energy that is absorbed primarily by tissue water and peptide bonds. The resulting localized tissue heating and vaporization produces tissue ablation with a residual thermal injury to the lower dermis. Traditional radiofrequency (RF) devices also use extreme heat (400-600 °C) to abruptly vaporize intracellular and extracellular fluids and cause tissue desiccation. In contrast, a new technology, Coblation®, utilizes a unique method of delivering RF energy for soft tissue removal applications in medicine, including dermatological surgery. Coblation uses bipolar wands to energize the particles in a conductive saline solution surrounding the target tissue to form a plasma field. The plasma has enough energy to break the tissue’s molecular bonds, creating an ablative path with minimal thermal effects (45-90 °C). Collateral tissue damage and tissue healing were investigated in several clinical studies, and compared to those observed with conventional electrosurgery. There was significantly less collateral tissue damage, less inflammation, and faster wound healing in Coblation-treated tissues. In a multicenter clinical study, Coblation was used for skin resurfacing for the treatment of facial wrinkles and provided statistically significant wrinkle improvement. When compared to CO2 laser, the decreased thermal effects of Coblation has led to less pain and faster recovery for most patients, yet the effect was enough to both stimulate new collagen production and to shrink collagen fibers. Coblation has the potential to be applied in most procedures where lasers have been used in the past in cosmetic and dermatological applications.

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