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Pulsed Electron Avalanche Knife (PEAK) Electrosurgery, one of the
most common surgical technologies, is considered a robust but somewhat crude
technique, with its basics changed surprisingly little since its invention
almost a century ago. Continuous radiofrequency is still used for tissue
cutting, with thermal damage extending to hundreds of micrometers. In
contrast, lasers developed seventy years later, have been constantly
perfected, and the laser-tissue interactions explored in great detail, which
has allowed tissue ablation with cellular precision in many laser
applications. We have recently shown
that pulsed electrosurgery with properly optimized waveforms and
microelectrodes can rival many advanced lasers. Pulsed electric waveforms
with burst durations in tens of microseconds applied via insulated planar
electrodes with micrometers-wide exposed edges can dissect tissues with the
collateral damage zone not exceeding cellular scale. Length of the electrodes
can vary from micrometers to centimeters and all types of soft tissues
– from membranes to cartilage and skin could be dissected in liquid
medium and in a dry field. This technology, called Pulsed Electron Avalanche
Knife (PEAK), is licensed PEAK
Surgical Inc., and is currently used in a wide variety of surgical
applications. We study interactions of pulsed electric field with
biological cells and tissues, including heat diffusion, coagulation,
vaporization, cavitation, ionization, electroporation and neural stimulation.
We develop applications of these interactions to minimally-traumatic surgical
and therapeutic technologies.
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