Establishment of evaluation method and influence of the various operative devices for the nerve in a laparoscopic autonomic nerve preserving operation

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As for the reason that it is not possible for to 100% in keeping it a function, it is thought that the heat damage of cautery use with lymph node dissection even if preserving nervous system. Influence for the nervous system of various devices : The detachment dew gave about 2cm thigh nervous system of a pig by a knife, cautery, harmonic, bipolar scissors and examined a change of a temperature of the nervous system and detachment distance from the nervous system and relations with a temperature. 【Result】 The temperature was an average of 227, 121, 69, 18 (℃) by the order that cautery> Harmonic> bipolar scissors> knife was each. The distance that nervous system temperature became less than 100(℃) was 1, 0.5, 0.2, 0(cm) by use of 15 seconds each. A static change by the heat damage : I extracted a copy of the nervous system just after a detachment exposure and I froze a part and saved it and Formalin fixed a part and made cDNA than a freeze specimen and examined expression at an RNA level … More of heatshock protein (HSP72) guided by the heat damage. I estimated damage degree of an axon as a nervous system sheath by S100 protein dyeing from a Formalin fixation specimen. 【Result】 HSP72 accepted expression in an electric scalpel, but did not develop with other devices. The nervous system sheath and the damage degree of an axon were 82, 14, 0, 0(%) each. Influence to give to a cancer organization of various devices : We did a slice of a Formalin fixation specimen and examined which depth in a tumor necrosis by the heat damage and neighboring apoptosis were guided to by HE dyeing and TUNEL method. 【Result】 By use of 15 seconds, apoptosis was guided each in a range of 3, 2, 0.5, 0(mm). Influence to give to a normal neurological function of various devices : A change of a source movement by evoked potential stimulation : With devices various with the pig thigh nervous system which exfoliated by a normal female as contrast added electricity stimulation to the thigh nervous system after having exfoliated, and weighed the neurotransmission speed change. 【Result】 Stimulation did not conduct it in an electric scalpel, and the other devices were equal with contrast. When I contact with nerve than the above and do cutting apart, the device which I was suitable for is bipolar scissors hold, but supersonic wave solidification incision device 5 is the equal. However, in that case, variability of a tumor becomes a problem. Bipolar scissors is most suitable and, for evasion and nervous system preservation of bleeding by an operation, should not use an cautery at a place keeping nerve. Less