Ultrasonic Surgical System Research Articles

New integrated ultrasonic surgical system, ‘Sonosurg’

A new surgical system named ‘SonoSurg’ integrating both the ultrasonic coagulating cutter and the conventional ultrasonic aspirator has been developed for clinical use. It maintains the functions of each independent device. Various types of hand pieces can be easily exchanged at the time of surgery. Moreover, all output switches are installed in the common foot switch. Therefore, the extent of the application of this system has been extremely expanded through these additional ancillary units with different function or varieties of hand pieces that are usable in accordance with the purposes. Experience with this system used in endoscopic or open surgeries at a couple of institutions is evaluated in this paper. We believe that the integration of these two different models will be very useful in various aspects, such as the improvement of surgical safety and to simplify surgical procedures as well as functional improvement of the operating theater.

Ultrasonic surgical system (SONOPET®) for microsurgical removal of brain tumors

We use the ultrasonic surgical system in the treatment of brain tumors such as meningioma, neurinoma, glioma, etc. SONOPET® is a useful and safe ultrasonic surgical system for microsurgery. The outer diameter of the tip of ultrasonic surgical systems is usually 2.5 mm and the inner diameter 2.0 mm. However, the outer diameter of the SONOPET® is 1.9 mm and the inner diameter 1.5 mm. Even in a deep site, because of the small diameter tip, the operation can be done easily. Further, the very thin outer diameter of the tip flue, 5 mm, makes it easy to operate in the deep site. The maximum amplitude of the distal end tip, which can be an important factor in tissue fragmentation, is 240 pm. It is said that the thinner tip breaks down easily, but by reducing metal fatigue the lifetime of the tip is longer and a larger amplitude can be obtained. As a result, hard tissue fragmentation becomes available even with a thinner tip. The handpiece is very light in weight, approximately 110 g, helping to reduce operator fatigue when in long term use. The weight is approximately one-half of conventional types. Because of the high efficiency of the electricity/vibration energy conversion rate, the handpiece does not heat up during the operation. Also, since water cooling is not necessary, the procedures before and after use are simple. Changing the handpiece during the operation is also easy. [Neurol Res 2000; 22: 490-494]

頭頚部外科領域での超音波手術機器の応用

頭頚部外科領域での超音波手術機器の応用

Efficacy of an Ultrasonic Surgical System for Laparoscopic Adrenalectomy

We determine the value of an ultrasonic surgical system for laparoscopic adrenalectomy. We analyzed 16 patients who underwent laparoscopic adrenalectomy using the ultrasonic surgical system and compared the results with those of patients undergoing laparoscopic adrenalectomy without the system. The system simplified exposure of the renal pedicles and inferior vena cava, and facilitated adrenal separation from the perinephric fat as well as dissection and identification of the adrenal vessels. Operating time was shorter and blood loss was also less with use of the ultrasonic surgical system. The ultrasonic surgical system simplified laparoscopic adrenalectomy and made the operation much safer.

Efficacy of an Ultrasonic Surgical System for Laparoscopic Adrenalectomy

Purpose We determine the value of an ultrasonic surgical system for laparoscopic adrenalectomy. Materials and Methods We analyzed 16 patients who underwent laparoscopic adrenalectomy using the ultrasonic surgical system and compared the results with those of patients undergoing laparoscopic adrenalectomy without the system. Results The system simplified exposure of the renal pedicles and inferior vena cava, and facilitated adrenal separation from the perinephric fat as well as dissection and identification of the adrenal vessels. Operating time was shorter and blood loss was also less with use of the ultrasonic surgical system. Conclusions The ultrasonic surgical system simplified laparoscopic adrenalectomy and made the operation much safer.

New cavitron system (CUSA/CEM): Its application for kidney surgery

A new Cavitron Ultrasonic Surgical Aspirator system (CUSA/CEM), which contains electrocautery function at the hand piece, was used for partial nephrectomies in dogs without clamping the renal artery. The advantages of this new device (CUSA/CEM) over the original CUSA are: (1) it enabled more precise resection of the tissue in a dry field, (2) shorter operating time, and eventually (3) helpful for reduction of blood loss. The microscopic examination of the resected kidney revealed minimal reaction and damage to the adjacent kidney tissue as compared with the effect by electrocautery or microwave tissue coagulator.

A STUDY ON POSTOPERATIVE COMPLICATIONS AFTER HEPATECTOMY WITH SPECIAL REFERENCE TO THE OPERATIVE METHODS

We investigated postoperative complications including pneumonitis, pleural effusion, intraabdominal abscess, and bile leakage in 134 patients treated with hepatectomy with special references to the method of hepatic transection, the extent and the site of resection. Patients were categorized into three groups according to the methods used for hepatic transection: microwave tissue coagulator (MTC) group (n=25); cavitron ultrasonic surgical aspiration system (CUSA) group (n=52); and the other group (n=57). Comparisons were also made among patients having limited hepatic resection (_??_HrS:n=70), intermediate resection (Hr1:n=20), and extensive resection (Hr2_??_;n=44). Furthermore, the limited resections of S7 and S8 were distinguished from those of other sites. Each postoperative complication in the MTC group tended to be higher than those in the other two groups. The rate of pneumonitis reached to as high as 32% in the MTC group, which was significantly higher than that (5.8%) of the CUSA group (p<0.01). In the MTC group, the bile leakage occurred more frequently in patients treated with extensive resection (83.3%) as compared to that with limited resection (5.3%, p<0.01). In patients with limited resections, postoperative complications such as pleural effusion, pneumonitis, and intraabdominal abscess occurred more frequently in S7 or S8 resection. Therefore, it is concluded that adequate drainage is of particular importance in controlling infection and bile leakage of the transacted margin after hepatectomy using MTC and that of S7 or S8.

超音波メスの使用経験

The advantages and limitations of the ultrasonic surgical system in spinal surgery are disccused in this report.We used SUMISONIC ME-24000, which transmits ultrasonic vibrations (maximum vibration 2400times/sec, maximum amplitude 200μm) to the horn tip. Since the horn tip is very thin, accurate, precise cutting and resection of hard tissue is possible using a light touch.Cool water is discharged by the horn tip, minimizing heat gererated from cutting, and also washs away dissolved tissue.It was very useful in spinal surgery, especially in surgical decompression of spinal cord of OPLL and OYL.The risk of damage to soft tissue appears to be very low, in comparison with surgiairtome.

The Effect of an Ultrasonic Surgical Aspiration System on the Heart and Blood Vessels.

The Effect of an Ultrasonic Surgical Aspiration System on the Heart and Blood Vessels.

A morphological study of the effect of the Cavitron ultrasonic surgical aspirator system near human peripheral nerves.

The Cavitron ultrasonic surgical aspirator system was used to clear superficial tissue from the greater auricular nerve in four human subjects. Following stimulation, the nerves were removed together with an untreated section and processed for examination by light microscopy. Significant damage had been sustained by these nerves, which was not apparent in the control sections. Disruption of the perineurium, intraneural hemorrhage, endoneural edema, and degenerative changes of the myelinated nerve fibers were seen. Damage to neural tissue was evident 0.5 to 1.5 mm in advance of the point of contact with the cutting tip.

術中超音波，マイクロウェーブ，超音波外科用吸引装置の三者併用肝切除について

術中超音波，マイクロウェーブ，超音波外科用吸引装置の三者併用肝切除について

The Cavitron ultrasonic aspirator in tumor surgery.

The CUSA Ultrasonic Surgical System fragments and aspirates a wide spectrum of firm tumors of the central nervous system with little transmitted movement to adjacent normal neural structures. The CUSA system is clearly of limited value in removing extremely calcified or dense fibrous tumors. It lacks primary hemostatic properties, and conventional hemostatic techniques are necessary.