Cervical intraepithelial neoplasia (CIN), the precursor of cervical cancer, is caused by persistent infection with human papillomavirus (HPV). In 2018, 570.000 cases of cervical cancer and 311.000 deaths were registered worldwide, which makes it the fourth most common cancer in women. Electrosurgery is a well-established field of plasma medicine since the mid-20th century and is used for all kinds of surgical interventions, such as precise cutting of tissue, resection of tumors, hemostasis and coagulation of bleeding wounds. A commonly used monopolar method for superficial coagulation and ablation of tissue is Argon Plasma Coagulation (APC). Here, the conductive channel between the active electrode and the surface of the patient develops in an argon gas flow, which is passed through the instrument to the treatment area. Such a plasma source using rigid and flexible probes was developed by Erbe Elektromedizin GmbH for various clinical applications. With maximal reduced settings, APC can be used non-thermally and thus mediate molecular effects, capable of selectively killing cancerous cells.
In a proof-of-principle study with 20 patients, as well as the first evaluation of 48 patients in an ongoing confirmatory study, a CIN remission of over 95.0 and 81.4 % could be shown, respectively. However, due to the current APC configuration which is usually used for rather local treatments it is currently difficult to achieve a homogeneous treatment of the cervix uteri. As a result, reproducible treatments of this complex area are highly dependent on the experience and know-how of the attending physician. Therefore, an optimized electrode configuration for treatment of CIN that is capable of homogeneous treatments of larger areas needs to be designed and analyzed regarding its efficacy and health-promoting effect especially regarding the WHO’s campaign to eliminate cervical cancer.
Here, the UKT, RUB and Erbe Elektromedizin GmbH pursue a unique approach to design and analyze an electrode configuration optimized for the specific treatment of the cervix uteri.
