Spray Coagulation - a potential equivalent to argon plasma coagulation
Intro
Welcome to this week's clinical digest from EndoCollab. When your argon plasma coagulation (APC) equipment fails or argon gas is unavailable, there's a practical alternative right in your toolkit—spray coagulation using a snare tip works on similar physical principles and produces comparable mucosal effects, potentially saving procedures from cancellation or delay. Free subscribers receive this weekly highlight, while paid members unlock our full archive, device demonstrations, comment section access, video courses, and our founding members' WhatsApp group for real-time collaboration. Ready for the deeper dive? Upgrade and join us.
Argon Plasma coagulation may not always be available because of gas shortage, lack of equipment or equipment breakdown. It is possible to generate ‘spray coagulation” using the tip of a snare. This was nicely shown in this case study by S. Rhati et al (iGIE 2023, see link below).
The authors: “Spray coagulation works on similar principles of physics as APC. The high voltage (around 4000 V, same as APC) at the electrode tip relative to the mucosa leads to electrostatic breakdown of the intervening air (78% N2, 21% O2) instead of argon, forming a plasma spark. The electrosurgical unit crest factor waveforms for both are also similar, generated by bursts of high voltage that quickly dampens as current stops flowing. Also, on endoscopic view, both seem to achieve a similar effect on the mucosa.”
Join the Members-Only Discussion
Have you used spray coagulation as an alternative to APC in your practice? We'd love to hear your experiences comparing effectiveness, learning curve, and tissue effects between the two techniques. For those who regularly perform thermal hemostasis, what's your go-to backup plan when primary equipment fails? Please share your protocols for achieving optimal coagulation with alternative tools during technical difficulties or supply shortages. See you in the comments!