title: Electromagnetic field system for transsphenoidal surgery on recurrent pituitary lesions - technical note.
abstract: BACKGROUND
  Post operative scar tissue makes transsphenoidal surgery for recurrent pituitary lesions very difficult. However, with the use of a new cautery system, known as the EMF system, we were able to perform the surgical procedures with relative ease. In this article, we report the advantages and clinical applications of this new instrument in transnasal reoperation.
  
  
  METHODS
  The EMF system generates a high frequency current of 13.56 MHz that is focused on the target. This enables it to coagulate, cut, and vaporize tissue in a pinpoint fashion. The bayonet and pencil-type hand pieces of the EMF system are slim, and the tips of the probe are flexible. This enables the surgeon to easily reach deep narrow spaces. We have used the EMF system for transsphenoidal surgery on recurrent pituitary lesions in 18 patients. The system was used to cut and vaporize scar tissue and vaporize firm and fibrotic tumor tissue.
  
  
  RESULTS
  During surgery, the system could easily cut and vaporize scarred tissues in the nasal cavity, the sphenoid sinus, and the sella, without damage to the surrounding tissue. In addition, in 3 patients who had extremely fibrotic and firm tumors, we were able to easily vaporize the tumor with safety.
  
  
  CONCLUSIONS
  The EMF system enables the surgeon to cut and vaporize tissue with ease and with minimal injury to the surrounding structures. It was particularly valuable in the resection of firm tumors. It may also shorten the operating time because of quick vaporization of the firm tissue.
authors.affiliation: Department of Neurosurgery, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan. takumi@med.showa-u.ac.jp
authors.forename: Takumi
authors.initials: T
authors.lastname: Abe
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tanioka
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugiyama
authors.forename: Michiari
authors.initials: M
authors.lastname: Kawamo
authors.forename: Kozo
authors.initials: K
authors.lastname: Murakami
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Izumiyama
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D004564:Electrocoagulation / Q000295:instrumentation* / Q000379:methods; D004574:Electromagnetic Fields; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013101:Sphenoid Sinus / Q000601:surgery; D016896:Treatment Outcome