Development of novel Argon Plasma instruments for superficial treatment of degenerated tissues and for cutting of metallic implants in the gastrointestinal tract.

Argon Plasma Surgery, improperly called Argon Plasma Coagulation (APC), is a noncontact thermal method that uses high-frequency monopolar current conducted to target tissues through ionized argon gas (argon plasma). Exploiting its properties and its many potential uses, two novel applications in the field of flexible endoscopy are here presented focusing the interest on the gastrointestinal (GI) tract where, cause of the reduced thickness of the organs walls, the risk of perforation is really high and therefore the safety of the applied method is the principal requirement. The cutting of metallic implants with particular regard to the OTSC® clip and the possibility to obtain a really low penetration depth of the APC thermal effects are the objects of this thesis developed at Ovesco Endoscopy AG (Tübingen, Germany). Different tests ex-vivo and in-vivo adopting the instruments realized ad hoc for the purposes above mentioned revealed respectively: even if possible, the cutting of the OTSC clip using APC technique shows some limits in terms of control of the process and in term of tissue integrity; the use of a resistive-capacitive element able to limit the current flowing into the tissue allows to obtain a really superficial treatment of tissues suggesting its applicability in the treatment of thin wall organs of the GI tract