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Surgical Endoscopy
Published in: Surgical Endoscopy 7/2011

01-07-2011

Endoscope system with plasma flushing and coaxial round jet nozzle for off-pump cardiac surgery

Authors: Tetsuya Horiuchi, Ken Masamune, Yuki Iwase, Hiromasa Ymashita, Hiroyuki Tsukihara, Noboru Motomura, Yuji Ohta, Takeyoshi Dohi

Published in: Surgical Endoscopy | Issue 7/2011

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Abstract

Background

To develop a new endoscope for performing simple surgical tasks inside the blood-filled cardiac atrium/chamber, that is, “off-pump” cardiac surgeries.

Methods

We developed the endoscope system with plasma flushing and coaxial round jet nozzle. The “plasma flushing” system was invented to observe the interior of the blood-filled heart by displacing blood cells in front of the endoscope tip. However, some areas could not be observed with simple flushing of the liquid because the flushed liquid mixed with blood. Further, a large amount of liquid had to be flushed, which posed a risk of cardiac damage caused by excess volume. Therefore, to safely capture high-resolution images of the interior of the heart, an endoscope with a coaxial round jet nozzle through which plasma is flushed has been developed. And to reduce the volume of flushed liquid, the synchronization system of heartbeat and the endoscope system with plasma flushing has been developed.

Results

We conducted an in vivo experiment to determine whether we could observe intracardiac tissues in swine without the use of a heart–lung machine. As a result, we successfully observed intracardiac tissues without using a heart–lung machine. By using a coaxial nozzle, we could even observe the tricuspid valve. Moreover, we were able to save up to 30% of the flushed liquid by replacing the original system with a synchronization system. And we evaluated the performance of the endoscope with the coaxial round jet nozzle by conducting fluid analysis and an in vitro experiment.

Conclusion

We successfully observed intracardiac tissues without using a heart–lung machine. By using a coaxial nozzle, we could even observe the tricuspid valve. And by replacing an original system to a synchronization system, we were able to save up to 30% of the flushed liquid. As a follow-up study, we plan to create a surgical flexible device for valve disease that can grasp, staple, and repair cardiac valves by endoscopic visualization
Literature
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Linte CA, Wiles AD, Hill N et al (2007) An augmented reality environment for image-guidance of off-pump mitral valve implantation. In: Proceedings of the SPIE International Symposium on Medical Imaging 2007, San Diego, CA, 17–22 February, pp 6509–6522
2.
Ming L, Mazilu D, Horvath K et al (2008) Robotic system for transapical aortic valve replacement with MRI guidance. LNCS (MICCAI 2008) 5242:476–484
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Tomasz AT, Sten LN, David TL et al (2004) Mitral annular size predicts Alfieri stitch tension in mitral edge-to-edge repair. J Heart Valve Dis 13:165–173
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5.
Masamune K, Mizutani M, Tsukihara H et al (2008) A new blood-permeable endoscope system with plasma flushing for off-pump cardiac surgery. Int J Comp Assist Radiol Surg 3(Suppl 1):S245–S246
6.
Masamune K, Kashiwabara K, Tsukihara S et al (2006) Basic study of blood-permeable endoscope for off-pump endovascular treatment. J Japan Soc Comp Aid Surg 8:190–191
7.
Boyd WD, Desai ND, Del Rizzo DF et al (1999) Off-pump surgery decreases postoperative complications and resource utilization in the elderly. Ann Thorac Surg 68:1490–1493PubMedCrossRef
Metadata
Title
Endoscope system with plasma flushing and coaxial round jet nozzle for off-pump cardiac surgery
Authors
Tetsuya Horiuchi
Ken Masamune
Yuki Iwase
Hiromasa Ymashita
Hiroyuki Tsukihara
Noboru Motomura
Yuji Ohta
Takeyoshi Dohi
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 7/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-010-1551-7

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