Holmium:YAG laser-induced liquid jet dissector: a novel prototype device for dissecting organs without impairing vessels.
Holmium:YAG laser-induced liquid jet dissector: a novel prototype device for dissecting organs without impairing vessels.
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DOI：
10.1055/s-2003-39339
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发表时间：
2003-04
期刊：
影响因子：
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通讯作者：
T. Hirano;H. Uenohara;M. Komatsu;A. Nakagawa;M. Satoh;H. Ohyama;K. Takayama;T. Yoshimoto
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文献类型：
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作者：
T. Hirano;H. Uenohara;M. Komatsu;A. Nakagawa;M. Satoh;H. Ohyama;K. Takayama;T. Yoshimoto
背景与目的神经外科一直需要一种不损伤主血管及邻近组织的脑组织解剖方法，以防止术后神经系统并发症的发生。在这项研究中，我们制造了这样一个原型装置，并试图用它来切除动物的肝脏，因为肝脏和大脑一样含有许多血管。材料与方法原型装置由一个喷嘴和一个吸入管组成。采用能量为230 mJ/脉冲的脉冲钬：YAG （Ho:YAG）激光从喷嘴中喷射出3hz的脉冲液体射流。用高速摄像机观察了液体射流的轮廓。使用该装置，在测量目标局部温度的同时，尝试对麻醉的家兔进行肝脏解剖。还进行了切开部分的组织学研究。结果液体射流以38 m/s的初始速度从喷嘴中直接射出。该装置切除肝实质，同时保留了细小的血管，并保持手术野的清晰。局部温度升高至不超过314 K（低于脑组织热损伤阈值）。在组织学检查中，解剖缘周围未见肝变性或坏死的迹象。结论Ho:YAG激光诱导液体喷射解剖机在经过一些小改进后，可应用于神经外科手术。
BACKGROUND AND OBJECTIVE Neurosurgery has long required a method for dissecting brain tissue without damaging principal vessels and adjacent tissue, so as to prevent neurological complications after operation. In this study we fabricated such a prototype device and used it in an attempt to resect an animal liver, which, like the brain, contains many vessels. MATERIALS AND METHODS The prototype device consisted of a jet nozzle and a suction tube. Pulsed liquid jets at 3 Hz were ejected from the nozzle by a pulsed holmium:YAG (Ho:YAG) laser at an irradiation energy of 230 mJ/pulse. The profile of the liquid jet was observed with a high-speed camera. With this device, liver dissections of anesthetized rabbits were attempted while measuring the local temperature of the target. A histological study of the incised parts was also performed. RESULTS The liquid jet was emitted straight from the nozzle at an initial velocity of 38 m/sec. The liver parenchyma was cut with the device while preserving the tiny vessels and keeping the operative field clear. The local temperature rose to no more than 314 K (below the heat damage threshold of brain tissue). In the histological findings, there were no signs of hepatic degeneration or necrosis around the dissected margin. CONCLUSIONS The Ho:YAG laser-induced liquid jet dissector can be applied to neurosurgical operations after incorporating some minor improvements.