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

至于不可能100%保持其功能的原因，认为即使保留神经系统，烧灼术的热损伤也与淋巴结清扫术一起使用。各种器械对神经系统的影响：分离露通过刀、烧灼、谐波、双极剪刀给猪的大腿神经系统约2cm，并检查神经系统的温度变化和与神经系统的分离距离以及与温度的关系。[结果]平均温度为227、121、69、18 ℃，依次为电烙器> Harmonic>双极剪>刀。神经系统温度变为低于100（℃）的距离分别为1、0.5、0.2、0（cm），各使用15秒。热损伤引起的静态变化：我提取了一个神经系统的拷贝，就在脱离暴露后，我冷冻了一部分并保存了它，福尔马林固定了一部分，制作了cDNA，而不是冷冻标本，并在RNA水平上检测了表达 ...更多信息 热休克蛋白72（HSP 72）的表达。通过福尔马林固定标本的S100蛋白染色，估计作为神经系统鞘的轴突的损伤程度。[结果] HSP72在电刀中接受表达，而在其他器械中不表达。神经系统鞘和轴突损伤程度分别为82、14、0、0（%）。各种器械对癌组织的影响：我们做了福尔马林固定标本的切片，并通过HE染色和TUNEL法检测了热损伤导致的肿瘤坏死和邻近细胞凋亡的深度。[结果] 15 s时，在3、2、0.5、0（mm）范围内均可诱导细胞凋亡。各种装置对正常神经功能的影响：通过诱发电位刺激改变源运动：以由正常雌性动物剥脱的猪大腿神经系统作为对照，在剥脱后对大腿神经系统增加电刺激，并衡量神经传递速度的变化。[结果]电刀不进行刺激，其他器械与对照品相当。当我接触神经比上述做切割时，我适合的器械是双极剪持，而超声波凝固切割器5是等同的。然而，在这种情况下，肿瘤的变异性成为问题。双极剪是最合适的，为了避免手术出血和保护神经系统，不应在保留神经的地方使用烧灼器。少

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