Surgery Today

, Volume 47, Issue 1, pp 122–129 | Cite as

Experimental analyses of the cavitation generated by ultrasonically activated surgical devices

  • Tao Gao
  • Bik Ee Lau
  • Tadashi Yamaguchi
  • Naoyuki Hanari
  • Hisashi Gunji
  • Masayuki Kano
  • Hisahiro Matsubara
  • Hideki Hayashi
Original Article
First Online:
Received:
Accepted:

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.

Keywords

Laparoscopic gastrectomy Pancreatic injury Energy device 
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Notes

Acknowledgments

The contribution of the second author, Bik Ee Lau, was equal to that of the first author. The authors thank M. Sekine (Center for Frontier Medical Engineering) for providing engineering assistance.

Compliance with ethical standards

Conflict of interest

The corresponding author, Hideki Hayashi has research and education grants from Ethicon-Endosurgery Japan, Tokyo, Japan, and Covidien Japan, Inc., Tokyo, Japan. Tao Gao and the other co-authors declare no conflicts of interest in association with this study.

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Copyright information

© Springer Japan 2016

Authors and Affiliations

  • Tao Gao
    • 1
  • Bik Ee Lau
    • 2
  • Tadashi Yamaguchi
    • 3
  • Naoyuki Hanari
    • 1
  • Hisashi Gunji
    • 1
  • Masayuki Kano
    • 1
  • Hisahiro Matsubara
    • 1
  • Hideki Hayashi
    • 1
    • 3
  1. 1.Department of Frontier Surgery, Graduate School of MedicineChiba UniversityChibaJapan
  2. 2.Graduate School of EngineeringChiba UniversityChibaJapan
  3. 3.Center for Frontier Medical EngineeringChiba UniversityChibaJapan

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