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Surgery Today
Published in: Surgery Today 1/2017

01-01-2017 | Original Article

Experimental analyses of the cavitation generated by ultrasonically activated surgical devices

Authors: Tao Gao, Bik Ee Lau, Tadashi Yamaguchi, Naoyuki Hanari, Hisashi Gunji, Masayuki Kano, Hisahiro Matsubara, Hideki Hayashi

Published in: Surgery Today | Issue 1/2017

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Abstract

Purpose

Recently, the incidence of postoperative pancreatic leakage has been reported to have significantly increased after laparoscopic gastrectomy for gastric cancers in comparison to open surgery. Although their lateral thermal spread has been shown to be smaller than that of other electrosurgical devices, ultrasonically activated surgical devices (USADs) have been suggested as one of the causes. We therefore hypothesized that cavitation generated by USADs could cause injuries to pancreatic tissue. Our retrospective study showed that the amylase activity in the drainage fluid of patients in whom surgery was performed using a USAD with a curved blade was significantly higher than that in patients in whom surgery was performed using a USAD with a straight blade. We therefore focused on the effects of straight and curved USAD blades.

Methods

The distribution of microbubbles generated in degassed water, which produce mechanical and biological tissue destructive forces, was measured and compared between the two types of USAD.

Results

More microbubbles were found to be generated from the side aspect of the curved blade, and the mechanical and biological destructive forces were found to be significantly higher than those generated by the side aspect of the straight blade.

Conclusions

These findings strongly suggest that cavitation generated by USADs could injure pancreatic tissues in the clinical cases. Surgeons should be aware of these properties of devices to achieve safe and secure surgeries.
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Metadata
Title
Experimental analyses of the cavitation generated by ultrasonically activated surgical devices
Authors
Tao Gao
Bik Ee Lau
Tadashi Yamaguchi
Naoyuki Hanari
Hisashi Gunji
Masayuki Kano
Hisahiro Matsubara
Hideki Hayashi
Publication date
01-01-2017
Publisher
Springer Japan
Published in
Surgery Today / Issue 1/2017
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-016-1345-1

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