Experimental Application of Pulsed Laser-Induced Water Jet for Endoscopic Submucosal Dissection: Mechanical Investigation and Preliminary Experiment in Swine.
Experimental Application of Pulsed Laser-Induced Water Jet for Endoscopic Submucosal Dissection: Mechanical Investigation and Preliminary Experiment in Swine.
复制标题
脉冲激光诱导水射流在内窥镜粘膜下剥离中的实验应用：猪的机械研究和初步实验。
DOI：
10.1111/j.1443-1661.2012.01375.x
复制
发表时间：
2012
影响因子：
5.3
通讯作者：
Yamada C
中科院分区：
文献类型：
--
作者：
Ando M;Takewa Y;Nishimura T;Yamazaki K;Kyo S;Ono M;Tsukiya T;Mizuno T;Taenaka Y;Tatsumi E;Yamada C
Background and AimA current drawback of endoscopic submucosal dissection (ESD) for early‐stage gastrointestinal tumors is the lack of instruments that can safely assist with this procedure. We have developed a pulsed jet device that can be incorporated into a gastrointestinal endoscope. Here, we investigated the mechanical profile of the pulsed jet device and demonstrated the usefulness of this instrument in esophageal ESD in swine.MethodsThe device comprises a 5‐Fr catheter, a 14‐mm long stainless steel tube for generating the pulsed water jet, a nozzle and an optical quartz fiber. The pulsed water jet was generated at pulse rates of 3 Hz by irradiating the physiological saline (4°C) within the stainless steel tube with an holmium‐doped yttrium‐aluminum‐garnet (Ho:YAG) laser at 1.1 J/pulse. Mechanical characteristics were evaluated using a force meter. The device was used only for the part of submucosal dissection in the swine ESD model. Tissues removed using the pulsed jet device and a conventional electrocautery device, and the esophagus, were histologically examined to assess thermal damage.ResultsThe peak impact force was observed at a stand‐off distance of 40 mm (1.1 J/pulse). ESD using the pulsed jet device was successful, as the tissue specimens showed precise dissection of the submucosal layer. The extent of thermal injury was significantly lower in the dissected bed using the pulsed jet device.ConclusionThe results showed that the present endoscopic pulsed jet system is a useful alternative for a safe ESD with minimum tissue injury.
