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Development of Ultrasonically Activated Bending Scalpel for Endoscopic Surgery

内窥镜手术用超声激活弯曲手术刀的研制

基本信息

批准号：
12555072
负责人：
HASHIMOTO Minoru
金额：
$ 7.74万
依托单位：
Shinshu University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2000
资助国家：
日本
起止时间：
2000 至 2001
项目状态：
已结题

项目摘要

Ultrasonically activated scalpels are used clinically to provide hemostatic cutting in endoscopic surgery. To assist the physician during endoscopic surgery, we developed an ultrasonically activated bending scalpel constructed of super elasticity alloy ( SEA in short ). First, we performed the vibration analysis and its verification in bending state of ultrasonically activated scalpel. We found out that longitudinal vibration was transmitted even if probe was bent. The influence of transverse vibration is very small. There is no trouble destroying tissue contacts with the probe. Next, a SEA bending probe and its bending angle control system were manufactured as an experiment. From the experiment using chicken, we evaluated the validity of the bending scalpel. From this research, we found out that it is possible to bend the probe of ultrasonically activated scalpel by using Super Elasticity Alloy, and the activation of ultrasonically activated scalpel could be realized.Although, a lot of surgeons have used ultrasonic coagulating and cutting systems and shears ( LCS ) in performing endoscopic thryroidectomies and parathyroidectomics and parathyroidectomies, our experience showed that some patients had temporary paralysis of the recurrent laryngeal nerve ( RLN ) after these operations. We sometimes noticed that the heat of the blade of the LCS was raised just after use; therefore, we designed the RLN model and investigated the damage to the RLN attributable to by heat of LCS. We investigated the effects of the heat of the blade of LCS upon rats' femoral and sciatic nerves using temperature measurements, histological examinations and evoked electromyography. Our results suggest that we should not touch the RLN directly with the blade just after using it, and that it is possible to use LCS at a distance of 3mm from the RLN for less than 20 sec at level 3. In order to maintain these distances requires visualizing the RLN in the view of endoscope at the neck surgery.

超声激活的手术刀在临床上用于内窥镜手术中提供止血切割。为了在内窥镜手术中辅助医生，我们开发了一种超声激活的超弹性合金弯曲刀(简称SEA)。首先，对超声手术刀在弯曲状态下的振动进行了分析和验证。我们发现，即使探头弯曲，纵向振动也会传播。横向振动的影响很小。破坏与探头的组织接触没有任何问题。其次，制作了海面弯曲探头及其弯曲角度控制系统作为实验。通过鸡的实验，对弯刀的有效性进行了评价。通过本研究，我们发现使用超弹性合金可以弯曲超声激活的手术刀的探头，实现超声激活的手术刀的激活。虽然许多外科医生已经使用超声凝固和切割系统和剪切器(LCS)进行内窥镜下甲状旁腺切除术和甲状旁腺切除术，但我们的经验表明，一些患者在这些手术后出现了暂时性的喉返神经瘫痪。我们有时会注意到LCS在使用后叶片的热量会升高，因此，我们设计了RLN模型，并研究了LCS的热对RLN的破坏。我们采用体温测量、组织学检查和诱发肌电图法，研究了腰锁髓鞘刀片热对大鼠股神经和坐骨神经的影响。我们的结果表明，在使用后不要直接用刀片接触喉返神经，在水平3的情况下，在距喉返神经3 mm的位置使用LCS是可能的。为了保持这些距离，在颈部手术中需要在内窥镜下可视化喉返神经。