ARGON-GAS-COAGULATION IN FLEXIBLE ENDOSCO PY - 1ST CLINICAL-EXPERIENCES

Argon-gas-coagulation represents a new method of contact free electroc oagulation, where RF-energy is applied to the tissue by means of ioniz ed argon-gas. In the operative field argon-gas-coagulation has been us ed with success for hemostasis in several parenchymatous organs and fo r devitalization of various tissues. Experimental studies have shown t he superiority of argon-gas-coagulation over standard electrocoagulati on and surgical techniques due to its high efficiency and limited tiss ue traumatization. Having developed and designed special endoscopic pr obes and after in-vitro-studies we could utilize the method in flexibl e endoscopy as well. From Juni 1991 to September 1992, 102 patients we re treated in 189 sessions with argon-gas-coagulation in the upper and lower gastrointestinal tract as well as respiratory system. The indic ations were: malignant and benign tumors, diffuse hemorrhages of vario us origins and of various sites, tissue overgrowth after stent-implant ation, remaining tissue after endoscopic adenomectomy and conditioning of fistulas prior to fibrin sealing. In all cases argon-gas-coagulati on in flexible endoscopy has been shown to be a very effective and eas y to perform technique with advantages in comparison to standard elect rocoagulation. Problems and complications have not been observed. The limited depth of tissue penetration (2-3 mm) coincident with efficient tissue coagulation allows the application even in critical areas such as the duodenum or colon. In many indications argon-gas-coagulation h as replaced the former widely used Nd-YAG-laser in our unit, Except va porisation of extended tumors, the argon-gas-coagulator shows remarkab le advantages for nearly all applications. These first clinical experi ences will be evaluated in further prospective clinical trials.