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Pulsed Electron Avalanche Knife (PEAK) Electrosurgery, one of the
most-often used surgical techniques, is considered a robust but somewhat crude
technology that has 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 10 micrometers-wide exposed edges can dissect tissues with
cellular precision: the collateral damage zone ranging from 2 to 10
micrometers. 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) has been successfully tested in human trials in vitreoretinal
and cataract surgeries. It has been licensed by the Stanford Office of
Technology Licensing to PEAK Surgical
Inc., and is currently been developed for 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 the pulsed electric field to minimally-traumatic surgical and
therapeutic technologies.
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