Skip to main content
SpringerLink
Log in

Application of actuator-driven pulsed water jet for coronary artery bypass grafting: assessment in a swine model

  • Original Article
  • Others
  • Published:
Journal of Artificial Organs Aims and scope Submit manuscript

Abstract

Actuator-driven pulsed water-jet (ADPJ) dissection is an emerging surgical method for dissecting tissue without heat and mechanical injury to vessels. We elucidated the mechanical properties of the piezo ADPJ and evaluated its usefulness and safety in coronary artery bypass grafting procedures. The relationship between the input voltage (10–100 V) and peak pressure of the pulsed water jet was evaluated. The tissue strengths of swine internal thoracic and coronary arteries and the surrounding tissues were measured to assure tissue-selective dissection. Internal thoracic arteries were harvested by conventional electric cautery and the water jet in four swine, and eight coronary arteries surrounded by myocardium were attempted to be exposed with the water jet. The dissected specimens were histologically evaluated. The peak pressure of the pulsed water jet was positively correlated with the input voltage (R 2 = 0.9984, P < 0.001). The breaking strengths of the target vessels (internal thoracic and coronary arteries) and the surrounding tissues were significantly different (P = 0.002 and P < 0.001, respectively). Histologic examination revealed that internal thoracic arteries were isolated with less heat damage using the pulsed water jet (P = 0.002) compared with electric cautery, and coronary arteries also were dissected without apparent histologic damage. ADPJ has the possibility of assuring tissue selectivity among the internal thoracic and coronary arteries. The results also indicated that the use of ADPJ may enhance safe procedures to harvest grafts during coronary artery bypass grafting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Kumar P, Yanagawa B, Tuneyosi H, Moussa F, Cohen G, Christakis G, Fremes S. Technique of harvesting an internal thoracic artery densely adherent to the periosteum. Ann Thorac Surg. 2010;90:681–2.

    Article  PubMed  Google Scholar 

  2. Higami T, Maruo A, Yamashita T, Shida T, Ogawa K. Histologic and physiologic evaluation of skeletonized internal thoracic artery harvesting with an ultrasonic scalpel. J Thorac Cardiovasc Surg. 2000;120:1142–7.

    Article  PubMed  CAS  Google Scholar 

  3. Bulat C, Pešutić-Pisac V, Čapkun V, Marović Z, Pogorelić Z, Družijanić N. Comparison of thermal damage of the internal thoracic artery using ultra high radiofrequency and monopolar diathermy. Surgeon. 2014;12:249–55.

    Article  PubMed  Google Scholar 

  4. Aydin U, Kocogullari CU. A method for locating embedded left anterior descending coronary arteries. Ann Thorac Surg. 2013;95:360–1.

    Article  PubMed  Google Scholar 

  5. Apostolakis E, Koletsis E, Leivaditis V, Lozos V, Dougenis D. A safe technique of exposing of a “hidden” left anterior descending artery. J Card Surg. 2007;22:505–6.

    Article  PubMed  Google Scholar 

  6. Oertel J, Gaab MR, Knapp A, Essig H, Warzok R, Piek J. Water jet dissection in neurosurgery: experimental results in the porcine cadaveric brain. Neurosurgery. 2003;52:153–9.

    PubMed  Google Scholar 

  7. Piek J, Wille C, Warzok R, Gaab MR. Waterjet dissection of the brain: experimental and first clinical results. J Neurosurg. 1998;89:861–4.

    Article  PubMed  CAS  Google Scholar 

  8. Rau HG, Duessel AP, Wurzbacher S. The use of water-jet dissection in open and laparoscopic liver resection. HPB (Oxford). 2008;10:275–80.

    Article  CAS  Google Scholar 

  9. Hirano T, Komatsu M, Saeki T, Uenohara H, Takahashi A, Takayama K, Yoshimoto T. Enhancement of fibrinolytics with a laser-induced liquid jet. Lasers Surg Med. 2001;29:360–8.

    Article  PubMed  CAS  Google Scholar 

  10. Nakagawa A, Hirano T, Jokura H, Uenohara H, Ohki T, Hashimoto T, Menezes V, Sato Y, Kusaka Y, Ohyama H, Saito T. Pulsed holmium:yttrium-aluminum-garnet laser-induced liquid jet as a novel dissection device in neuroendoscopic surgery. J Neurosurg. 2004;101:145–50.

    Article  PubMed  Google Scholar 

  11. Ohki T, Nakagawa A, Hirano T, Hashimoto T, Menezes V, Jokura H, Uenohara H, Sato Y, Saito T, Shirane R, Tominaga T. Experimental application of pulsed Ho: YAG laser-induced liquid jet as a novel rigid neuroendoscopic dissection device. Lasers Surg Med. 2004;34:227–34.

    Article  PubMed  Google Scholar 

  12. Ogawa Y, Nakagawa A, Takayama K, Tominaga T. Pulsed laser-induced liquid jet for skull base tumor removal with vascular preservation through the transsphenoidal approach: a clinical investigation. Acta Neurochirur (Wien). 2011;153:823–30.

    Article  Google Scholar 

  13. Ogawa Y, Nakagawa A, Washio T, Arafune T, Tominaga T. Tissue dissection before direct manipulation to the pathology with pulsed laser-induced liquid jet system in skull base surgery—preservation of fine vessels and maintained optic nerve function. Acta Neurochir (Wien). 2013;155:1879–86.

    Article  Google Scholar 

  14. Yamada M, Nakano T, Sato C, Nakagawa A, Fujishima F, Kawagishi N, Nakanishi C, Sakurai T, Miyata G, Tominaga T, Ohuchi N. The dissection profile and mechanism of tissue-selective dissection of the piezo actuator-driven pulsed water jet as a surgical instrument: Laboratory investigation using swine liver. Eur Surg Res. 2014;53:61–72.

    Article  PubMed  Google Scholar 

  15. Yamashita S, Kamiyama Y, Nakagawa A, Kaiho Y, Tominaga T, Arai Y. Novel pulsed water jet system permits off-clamp partial nephrectomy in swine. Int J Urol. 2014;21:1181–2.

    Article  PubMed  Google Scholar 

  16. Seto T, Yamamoto H, Takayama K, Nakagawa A, Tominaga T. Characteristics of an actuator-driven pulsed water jet generator to dissecting soft tissue. Rev Sci Instrum. 2011;82:055105.

    Article  PubMed  CAS  Google Scholar 

  17. Ebrahimi AP. Mechanical properties of normal and diseased cerebrovascular system. J Vasc Interv Neurol. 2009;2:155–62.

    PubMed  PubMed Central  Google Scholar 

  18. Grenier R, Périé D, Gilbert G, Beaudoin G, Curnier D. Assessment of mechanical properties of muscles from multi-parametric magnetic resonance imaging. J Biomed Sci Eng. 2014;7:593–603.

    Article  Google Scholar 

Download references

Acknowledgements

The authors appreciate the assistance of Teruko Sueta and Nobuko Hashimoto from the Center for Laboratory Animal Research, Tohoku University, and Ayako Ono from the experimental laboratory at the Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine for technical assistance. The authors thank Mr. Takeshi Seto and Mr. Yasuyoshi Hama for preparing the surgical instruments. The authors thank Dr. Yuriko Saiki for her expertise with histopathological assessment and Ms. Asaka Ishigamori for administrative assistance.

Author information

Authors and Affiliations

  1. Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryocho, Aoba-ku, Sendai, Miyagi, Japan

    Tomoyuki Suzuki, Shunsuke Kawamoto, Masatoshi Akiyama, Osamu Adachi, Kiichiro Kumagai & Yoshikatsu Saiki

  2. Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan

    Atsuhiro Nakagawa, Toshiki Endo & Teiji Tominaga

Authors
  1. Tomoyuki Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shunsuke Kawamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Atsuhiro Nakagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Toshiki Endo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Teiji Tominaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masatoshi Akiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Osamu Adachi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kiichiro Kumagai
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yoshikatsu Saiki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Tomoyuki Suzuki or Yoshikatsu Saiki.

Ethics declarations

Funding

This work was supported in part by the Translational Research Network Program, B13, Grants-in Aid for Scientific Research (C) (26462196, 26462197, 24592049, and 15K10353), (A) (15H01707), and (B) (26282116 and 15H04945) from the Japanese Ministry of Education, Culture, Sports, Science, and Technology. The piezo ADPJ system was supplied by Seiko Epson Corporation as part of a collaborative research contract with Tohoku University.

Conflict of interest

Nakagawa and Tominaga received research funding support from Seiko Epson Co., Ltd. under a collaborative research contract with Tohoku University; otherwise, none were reported.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Suzuki, T., Kawamoto, S., Nakagawa, A. et al. Application of actuator-driven pulsed water jet for coronary artery bypass grafting: assessment in a swine model. J Artif Organs 21, 247–253 (2018). https://doi.org/10.1007/s10047-017-1008-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10047-017-1008-z

Keywords

Search

Navigation