PK TURP utilizes Advanced Bipolar design that incorporates the active and return poles on the same electrode (Figure 1) rather than the patient return pad used in traditional Monopolar TURP.

Figure 1 Electrical current flow during PK TURP

Significantly lower voltages (220–320Vrms) can be used to push electrical current around the bipolar circuit. This is a fraction of the high voltages (1,000–3,000Vrms) used in monopolar designs. The effect is to reduce localized tissue damage, preventing charring and damage to underlying blood vessels that may subsequently slough off or open due to patient movement (Figure 2).

Figure 2 Minimal tissue trauma with PK TURP due to lower voltage

The result of this technology is improved clinical outcomes for patients that continue to be published, with over 2500 patients having been enrolled in studies worldwide.

A plasma corona is generated around the loop such that tissue molecules entering this highly energized field are vaporized creating a cutting effect. The PK waveform has been tuned to enable concomitant hemostasis during resection. When retraction of the loop is done at the appropriate speed, sufficient thermal energy remains on the tissue to enable coagulation of capillary bleeders (Figure 3). The effect gives clear, hemostatic resection but is sufficiently shallow to prevent irritative symptoms observed with laser technologies.

Figure 3 Plasma corona resulting in concomitant hemostasis during PK TURP

Superpulse: To ensure rapid plasma fire off, the Superpulse generator incorporates a bank of capacitors to hold an electrical charge ready for the next activation. This allows operation under a range of conditions including high saline flow and high tissue impedance.

Coagulation: To prevent plasma formation, the voltage is reduced (120Vrms) such that coagulation relies on tissue resistive heating. The appropriate depth of coagulation is achieved by firm application of pressure for sufficient time to control bleeders. A wide circumferential thermal zone compared to monopolar enables larger bleeders to be controlled. The tissue effect achieved results in a moist white coagulum that will not slough off during the healing process unlike the charred desiccated tissue generated with monopolar electrosurgery.

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