title: The tissue effect of second generation argon plasma coagulation (VIO APC) in comparison to standard APC and Nd:YAG laser in vitro.
abstract: BACKGROUND
  The aim of this study was to evaluate the effect of 2nd generation argon plasma coagulation (VIO APC) with respect to the tissue destruction capacity, and to compare it with standard APC and Nd:YAG laser.
  
  
  METHODS
  2nd generation APC (VIO APC2, Erbe, Germany), standard APC (APC 300/Erbotom ICC 200, Erbe) and Nd:YAG laser (KTP/YAG XP 800; Laserscope, San Jose, California) were applied in 35 porcine livers. Using APC, power settings (30-120 W), application time (2 and 5 sec) and gas flow (1 and 2 l/min) were varied. Using Nd:YAG laser, 30-60 W were applied (flow 21/min). Diameter and depth of tissue coagulation were evaluated.
  
  
  RESULTS
  Using VIO APC, maximum coagulation depth was 6 mm (maximum diameter 15 mm). In comparison to standard APC, the coagulation effect was significantly higher (p < 0.001). There was no significant difference in the mean depth achieved by VIO APC and Nd:YAG laser using 30- 60 W and an application time of 2 sec (p < 0.05). Using maximum energy available for the 2 systems, maximum depth achieved by VIO APC (6 mm) was higher than the one caused by Nd:YAG laser (4 mm).
  
  
  CONCLUSIONS
  VIO APC was more effective than standard APC. Using medium power and a limited application time, it was as effective as Nd:YAG laser. The high effectiveness of VIO APC should be a topic of clinical education.
authors.affiliation: Department of Internal Medicine II, HSK Wiesbaden, Wiesbaden, Germany. HSManner@gmx.de
authors.forename: Hendrik
authors.initials: H
authors.lastname: Manner
authors.forename: Andrea
authors.initials: A
authors.lastname: May
authors.forename: Michael
authors.initials: M
authors.lastname: Faerber
authors.forename: Oliver
authors.initials: O
authors.lastname: Pech
authors.forename: Nicola
authors.initials: N
authors.lastname: Plum
authors.forename: Christian
authors.initials: C
authors.lastname: Ell
mesh_terms: D000818:Animals; D004867:Equipment Design; D017075:Laser Coagulation / Q000379:methods*; D054020:Lasers, Gas / Q000627:therapeutic use*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology / Q000601:surgery; D023421:Models, Animal; D013552:Swine