Application of underwater shock wave and laser-induced liquid jet to neurosurgery
Application of underwater shock wave and laser-induced liquid jet to neurosurgery
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DOI：
10.1007/s00193-005-0005-y
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发表时间：
2006-02
期刊：
影响因子：
2.2
通讯作者：
T. Tominaga;A. Nakagawa;T. Hirano;J. Sato;K. Kato;S. Hosseini;K. Takayama
中科院分区：
文献类型：
--
作者：
T. Tominaga;A. Nakagawa;T. Hirano;J. Sato;K. Kato;S. Hosseini;K. Takayama
论文论述了水下冲击波在医学上的应用。简要介绍了利用脉冲Ho:YAG激光束在水中照射产生水下冲击波的历史发展，并对冲击波在神经外科中的潜在应用进行了概述。激光束在充液导管内照射产生水蒸气泡，冲击波从导管出口以受控方式间歇产生微液体射流。强调了激波动力学和气泡动力学之间的相关性。为了优化射流运动，简要介绍了基本参数研究的结果。从导管出口排出的液体射流具有足够高的冲量，可以清楚地显示出各种医疗用途的有效性。在液体射流中，我们观察到相当强的冲击波，因此发明了一种紧凑型冲击波发生器，旨在应用于显微外科手术。我们将其应用于大鼠的骨窗，并开发了一种有效的脑保护方法来抵抗冲击负荷。Gore-Tex®片材的插入被发现即使在很短的距离内也能急剧衰减冲击波，并阐明了其物理机制。激光诱导液体射流（LILJ）成功应用于软组织解剖。进行了动物实验，并详细介绍了组织学观察结果。动物实验结果表明，LILJ能以最小的耗液量对软组织进行快速解剖，并能保存直径大于0.2 mm的血管。冲击波和LILJ有可能成为神经外科手术中不可或缺的工具。
Paper deals with applications of underwater shock waves to medicine. A historical development of underwater shock wave generation by using pulsed Ho:YAG laser beam irradiation in water is briefly described and an overview is given regarding potential applications of shock waves to neuro-surgery. The laser beam irradiation in a liquid-filled catheter produces water vapor bubble and shock waves intermittently produces micro-liquid jets in a controlled fashion from the exit of the catheter. Correlations between shock dynamics and bubble dynamics are emphasized. To optimize the jet motion, results of basic parametric studies are briefly presented. The liquid jet discharged from the catheter exit has an impulse high enough to clearly exhibit effectiveness for various medical purposes. In liquid jets we observed reasonably strong shock waves and hence invented a compact shock generator aiming to apply to microsurgery. We applied it to a rat's bone window and developed an effective method of brain protection against shock loading. The insertion of Gore-Tex® sheet is found to attenuate shock waves drastically even for very short stand off distance and its physical mechanism is clarified. The laser-induced liquid jet (LILJ) is successfully applied to soft tissue dissection. Animal experiments were performed and results of histological observations are presented in details. Results of animal experiments revealed that LILJ can sharply dissect soft tissue with a minimum amount of liquid consumption, while blood vessels larger than 0.2 mm in diameter are preserved. Shock waves and LILJ have a potential to be indispensable tools in neuro-surgery.