J Neurol Surg A Cent Eur Neurosurg 2019; 80(02): 096-101
DOI: 10.1055/s-0038-1675782
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Usefulness of a Newly Developed Ultrasonic Microdissector in Neurosurgery: A Preliminary Experimental Study

Toshihiro Ogiwara
1   Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
,
Tetsuya Goto
1   Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
,
Yusuke Fujii
2   J. Morita Mfg. Corp., Kyoto, Japan
3   Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
,
Yoshiki Hanaoka
1   Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
,
Kazuhiro Hongo
1   Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
,
Jun Okamoto
3   Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
,
Yoshihiro Muragaki
3   Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
› Institutsangaben

Funding Source The research was supported by a grant from the Promotion Project of Education, Research, and Medical Care from Shinshu University Hospital.
Weitere Informationen

Publikationsverlauf

27. Juni 2018

28. August 2018

Publikationsdatum:
24. Dezember 2018 (online)

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Abstract

Background Dissection and division of tissues are widely performed in microscopic neurosurgery, especially in brain tumor resection. Dissection maneuvers can be divided into two types: sharp dissection with microscissors and blunt dissection using a dissector. It is essential to use the appropriate method according to the intraoperative situation and conditions. Therefore, specific tools for each type of dissection maneuver are required. We developed an ultrasonic microdissector, a newly designed tool that functions as both microscissors and dissector to further advance brain tumor surgery. This preliminary experimental study was performed to evaluate the usefulness of this new device.

Methods Solfy F (J. Morita Mfg. Corp., Kyoto, Japan), a dental ultrasonic instrument, was used to provide power in this study. Two experiments were performed. The first one involved touching the brain parenchyma of a pig cadaver with the tip of the ultrasonic microdissector under various conditions to investigate its side effects. In the second experiment, the rat femoral artery, vein, and nerve were dissected from surrounding structures using a prototype of the ultrasonic microdissector. The effects of this device were then investigated histologically.

Results The amount of tissue damage was greater with the higher ultrasonic power. No irrigation and a long manipulation time also affected tissue degeneration. Dissection using the ultrasonic microdissector was superior to conventional dissection methods in terms of time (p < 0.05) and safety without any additional histologic damages.

Conclusions The newly developed ultrasonic microdissector can dissect soft tissue without damage to the surrounding tissue. Further studies are required to determine the optimal intensity for its clinical use.

Animal Experiments

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice where the studies were conducted.