Abstract
Objective Maximum resection with minimum damage to normal structures is required for a better
clinical outcome. Several efficient surgical devices such as the Cavitron ultrasonic
surgical aspirator are available. Our group developed the actuator-driven pulsed water
jet (ADPJ) to dissect soft tissue with vessel preservation. Although these devices
are very effective for resection, tumor seeding is a potential risk. The present study
investigated the control of splashing during ADPJ use. We demonstrate the effect of
additional water flow around the instrument tip to veil the splashing.
Methods Pulsed water jet was ejected from the tip of the ADPJ nozzle. Effects of ADPJ parameters
such as input voltage, suction pressure, and distance between the nozzle and the target
(standoff distance) on the amount of splashing were analyzed. Methylene blue solution
was ejected on photo paper, gelatin brain phantom, and porcine brain harvested and
subsequently immersed into physiologic saline to quantify the amount of splashing.
Results High-input voltage and a long standoff distance had significant correlations with
large amounts of splashing (r > 0.5; p < 0.01). However, suction pressure had no correlation (r = 0.23). Additional water
flow combined with the ADPJ decreased the amount of splashing. A high-speed camera
recording revealed that the additional water flow formed a water veil that prevented
droplet dispersion, as confirmed with experiments using the brain phantom and porcine
brain, in which the irregularity and elasticity are specific.
Conclusions The veil effect of additional water flow is important to reduce splashing during
ADPJ use and can minimize the potential risk of dissemination and enhance the safety
of the ADPJ.
Keywords
pulsed water jet - minimally invasive surgery - new surgical instrument - water veil
effect
