APC Procedure

  • Jennifer Grace Biomedical Sciences, The University of Manchester, UK

Overview

The Argon Plasma Coagulation (APC) process is a noteworthy development in the realm of minimally invasive medical procedures and treatments. Ionized argon gas is applied to produce controlled coagulation and consequent tissue damage. After being created in the second part of the 20th century, the method has quickly advanced to become a useful instrument in several medical specialities, including gynaecology, pulmonology, and gastroenterology.

This article aims to give readers a thorough understanding of the Argon Plasma Coagulation Procedure by illuminating its basic principles, historical evolution, and numerous applications in the field of contemporary medicine. This article seeks to highlight the critical role that APC plays in the successful treatment of a wide range of medical illnesses and disorders by examining the complex mechanisms underlying the technology and its clear advantages over conventional coagulation methods.

Understanding argon plasma coagulation (APC) procedure

Argon Plasma Coagulation (APC) is a cutting-edge medical procedure that produces controlled coagulation and tissue damage by utilizing the special qualities of ionized argon gas. During the process, argon gas is ionized with a high-frequency electrical current and then discharged through a catheter to form a concentrated plasma beam.1 When this plasma beam strikes the intended tissue, it causes localized heating and subsequent coagulation, which effectively closes up blood arteries and destroys tissue that is undesirable or sick. Because it is accurate and less intrusive, this approach has become more and more popular in the medical sector. It allows for targeted treatment without seriously harming nearby healthy tissues.2

Comprehending the key principles and mechanisms of APC is necessary to recognise its applicability in a range of healthcare settings. APC has several advantages, unlike conventional coagulation methods, like electrocautery or laser therapy. One such advantage is its capacity to produce surface coagulation with minimal tissue penetration, lowering the possibility of collateral injury. Furthermore, because the process is non-contact, medical practitioners can accurately target sensitive or difficult-to-reach bodily parts, which makes it very useful in complex medical operations.3

Applications of argon plasma coagulation procedure

Argon Plasma Coagulation (APC) has found widespread application across various medical fields, revolutionizing the treatment of a diverse range of conditions and diseases. One of the primary areas where APC has proven to be particularly effective is gastrointestinal endoscopy. APC is used by gastroenterologists to treat a variety of gastrointestinal diseases, such as bleeding ulcers, tiny polyp excision, and ablation of anomalous tissue growths in the gastrointestinal tract.4 Furthermore, APC is a valuable treatment for tracheal stenosis, bronchial cancer, and other pulmonary illnesses that require precise tissue coagulation in the field of pulmonology.5

Additionally, urologists and gynaecologists have included APC in their practices to treat a variety of disorders involving the urinary and reproductive systems. Surgical excision of cervical and vaginal lesions and postpartum haemorrhage management are two uses of APC in gynaecology.6 In a similar vein, urologists use APC to treat blockages of the urinary tract, such as urethral strictures and bladder tumours, making use of its accurate coagulation properties to guarantee the best possible outcomes for their patients.7

The importance of APC in these medical applications lies in its ability to deliver targeted and controlled coagulation, enabling healthcare professionals to treat complex medical conditions with greater precision and less risk of collateral damage.1 APC has made a substantial improvement to treatment outcomes and patient care across a range of medical disciplines by providing a secure and reliable substitute for conventional surgical methods.

Procedure and techniques of argon plasma coagulation

APC requires several critical stages that must be followed to guarantee the technique’s safe and effective use in a variety of medical contexts. The careful setup of the apparatus, which includes the argon gas delivery system and the customized APC catheter, is one of the main components of the process.8 Before beginning the procedure, healthcare providers should make sure that the equipment is calibrated and operating correctly to ensure accurate and regulated coagulation during the therapy process.

Healthcare professionals need to be cautious and precise when performing the APC technique to precisely transport the ionized argon gas to the target tissue. To obtain the intended coagulation effect, a detailed study of the anatomical structure, the particular medical condition being treated, and the best settings for the APC device are needed.2 Strict safety guidelines must also be followed to reduce the possibility of complications and ensure the patient’s well-being throughout the procedure.

Benefits and limitations of argon plasma coagulation

Argon plasma coagulation (APC) is a preferred procedure in a variety of medical operations due to its many benefits. APC’s ability to precisely target and coagulate particular tissues makes it possible to administer regulated, targeted treatments without seriously harming nearby healthy tissues.3 This is one of its main advantages. Maintaining the integrity of surrounding tissues is critical for the best possible outcomes for patients during delicate medial operations, which is where this exact coagulation capacity comes in very handy. APC’s least invasiveness also helps patients recover more quickly and with less discomfort, which improves their entire experience and recuperation after the surgery.2

APC is also well-known for its versatility, as it can be applied to a wide range of medical specialties, such as urology, gynecology, gastroenterology, and pulmonology. This makes it a useful tool for medical professionals working in interdisciplinary teams. APC has greatly improved patient care and treatment outcomes in a variety of healthcare settings by providing a secure and reliable substitute for conventional surgical procedures.

Despite its numerous advantages, Argon Plasma Coagulation also has several limitations. The possibility of thermal injury to the surrounding tissues is one of the primary limitations if the process is not carried out with the highest level of care and precision.1 Healthcare practitioners need to be aware of the parameters and settings needed for any medical condition to reduce the possibility of problems and guarantee patient safety throughout the process. Furthermore, the type of medical problem being treated and the particular anatomical place may have an impact on how effective APC is;2 therefore, each patient must have a comprehensive evaluation and individualized treatment plan.

Best practices and guidelines for argon plasma coagulation

To guarantee the safe and efficient administration of Argon Plasma Coagulation (APC), it is imperative that medical practitioners follow a set of best practices and standards when implementing this procedure. Healthcare workers need to be well-versed in the use of APC tools and procedures, including knowing exactly what settings and parameters are needed for certain medical situations. Continual education initiatives and skill-building seminars are essential for keeping practitioners abreast of the most recent developments and industry best practices in APC.

FAQs

What to expect during the procedure?

In many ways, APC isn’t that different from a typical endoscopic procedure. The process begins with the endoscopist collecting you from the changing room and escorting you to a private bay to complete a consent form. Then, you will be guided to the procedure room, where the team will introduce themselves and ask some questions to ensure you are prepared for the procedure. In the procedure room, you will be asked to remove false teeth, glasses, and hearing aids on the left side and will be positioned comfortably on your left side on a couch. The endoscopist will administer an injection or throat spray, and a plastic guard will be placed in your mouth for safety. A plastic 'peg' will monitor your pulse and oxygen levels, while a sticky pad may be attached to your thigh for connection to the APC equipment if needed. Throughout the procedure, a trained nurse will remain with you for your comfort and reassurance. It's normal to experience some gagging as the endoscope is inserted, but this won't affect your breathing. The introduction of air into your stomach during the procedure might cause some burping or belching, which can be uncomfortable for some. Restraint might be used minimally, but if you express discomfort, the procedure will be stopped promptly.9

What to expect after the surgery?

APC treatments are often finished in less than an hour. However, there are some deviations based on the quantity and severity of the lesions. The doctor will send you home with instructions for the next week when the APC is finished, and they will report on how things went. 

Most patients only have mild discomfort, if any, which is easily controlled with over-the-counter analgesics. You should follow a liquid diet for the first 24-48 hours. You could also be told to follow a soft diet for the next week. This promotes healing and reduces the possibility of infection or other problems at the treatment locations.10

Summary

Argon Plasma Coagulation (APC) is a minimally invasive medical procedure that utilizes ionized argon gas for precise coagulation and tissue damage, finding widespread application in fields like gastroenterology, pulmonology, and gynaecology. The article provides a comprehensive insight into the principles and historical evolution of APC, emphasizing its advantages over traditional methods and its critical role in treating various medical conditions. It highlights the meticulous procedure requirements and the significance of following the best practices and safety guidelines to ensure optimal patient care. During the APC procedure, patients undergo preparatory measures, lie on their left side, and may experience slight discomfort, such as gagging and stomach bloating. Post-surgery care involves adhering to a liquid diet to promote healing and prevent infections at the treatment sites.

References

  1. Zenker M. Argon plasma coagulation. GMS Krankenhaushygiene Interdisziplinar [Internet]. 2008 Nov 3;3(1):Doc15. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831517/ 
  2. ‌Sagawa T, Takayama T, Oku T, Hayashi T, Ota H, Okamoto T, et al. Argon plasma coagulation for successful treatment of early gastric cancer with intramucosal invasion. Gut [Internet]. 2003 Mar 1 [cited 2023 Oct 20];52(3):334–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773547/ 
  3. ‌Argon Plasma Coagulation (APC) – Brigham and Women’s Hospital [Internet]. www.brighamandwomens.org. [cited 2023 Oct 20]. Available from: https://www.brighamandwomens.org/cwmw/argon-plasma-coagulation-apc 
  4. ‌Argon Plasma Coagulation for Weight Loss [Internet]. www.hopkinsmedicine.org. 2022 [cited 2023 Oct 20]. Available from: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/argon-plasma-coagulation-for-weight-loss#:~:text=APC%20is%20a%20procedure%20that 
  5. ‌Ching YH, Geck RD, Andrews AD, Rumbak MJ, Camporesi EM. Argon plasma coagulation in the management of uncovered tracheal stent fracture. Respiratory Medicine Case Reports [Internet]. 2014 Jan 1 [cited 2023 Oct 20];13:37–8. Available from: https://www.sciencedirect.com/science/article/pii/S2213007114000422#:~:text=Argon%20plasma%20coagulation%20(APC)%20
  6. ‌Sultania S, Sarkar R, Das K, Dhali GK. Argon plasma coagulation is an effective treatment for chronic radiation proctitis in gynaecological malignancy: an observational study. Colorectal Disease: The Official Journal of the Association of Coloproctology of Great Britain and Ireland [Internet]. 2019 Apr 1 [cited 2023 Oct 20];21(4):465–71. Available from: https://pubmed.ncbi.nlm.nih.gov/30585689/ 
  7. ‌ Reich O, Schneede P, Mseddi A, Zaak D, Siebels M, Hofstetter A. Argon plasma coagulation (APC) for endo-urological procedures: ex-vivo evaluations of hemostatic properties. European Urology [Internet]. 2003 Aug 1 [cited 2023 Oct 20];44(2):272–6. Available from: https://pubmed.ncbi.nlm.nih.gov/12875949/ 
  8. ‌Enteroscopy with and without argon plasma coagulation (APC) [Internet]. Cambridge University Hospitals. Available from: https://www.cuh.nhs.uk/patient-information/enteroscopy-with-and-without-argon-plasma-coagulation-apc/ 
  9. ‌Argon Plasma Coagulation (APC) Offers a Safer and More Efficient Treatment Option | Dr. Samuel N. Marcus M.D., Ph.D [Internet]. Samuel N. Marcus M.D., Ph.D. [cited 2023 Oct 20]. Available from: https://www.marcusgi.com/argon-plasma-coagulation-apc/#:~:text=Most%20patients%20experience%20only%20mild 
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Jennifer Grace

Biomedical Sciences, The University of Manchester

My name is Jennifer Grace, and this September marks the beginning of my final year pursuing BSc. (Hons) Biomedical Science studies at the University of Manchester. Born in Indonesia, I embarked on a journey fueled by curiosity. From a young age, my passion for Biology and healthcare framework emerged, propelling my achievements of biological science. Driven by my ardour for scientific exploration, I have actively engaged with various organizations dedicated to environmental and healthcare frameworks. My commitment to advancing science found expression through my participation in the Klarity internship program as an article writer to improve my writing skills, especially scientific writing skills. With each step, I'm unflinchingly dedicated to blending my affection for science with a significant feeling of direction for my career.

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