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Development of an articulating ultrasonically activated device for laparoscopic surgery

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Abstract

Background

Ultrasonically activated devices (USADs) offer excellent coagulating dissection performance and are broadly used, particularly in endoscopic operations. Traditional USADs, however, have fixed linear shape and are thus limited in the directions from which organs can be approached. We have developed a small USAD transducer attached to the tip of an articulating device, offering a new kind of USAD in which the tip can bend as desired. We describe herein an evaluation of the coagulating dissection performance of this new articulating USAD and an in vivo confirmation of clinical usefulness.

Methods

To evaluate coagulating dissection performance, we compared coagulating shearing on porcine splenic arteries between the articulating USAD and a Harmonic Scalpel II (HSII), representing a traditional USAD. Changing the amplitude of vibration between 60 μm and 80 μm and grip force among 1, 2, and 3 N, we measured the time required for division and bursting pressure of coagulating dissection. An in vivo experiment in a pig was also used to confirm the usefulness of the articulating USAD in laparoscopic operations.

Results

Division time did not differ significantly between the articulating USAD and HSII with an 80-μm amplitude of vibration and a grip force of 2 or 3 N. Bursting pressure of blood vessels showed no significant difference between articulating USAD and HSII under all experimental conditions. In the in vivo experiment, the new bendable tip of the articulating USAD displayed coagulating dissection performance equivalent to that of the traditional USAD.

Conclusions

We have developed a new articulating USAD that can broaden the range of methods and approaches available for USADs and improve usefulness and safety.

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Acknowledgements

The authors would like to thank Drs. Ichiro Sakuma, Etsuko Kobayashi, Takashi Suzuki, and Mr. Takeshi Hasuo (The University of Tokyo) for technical support. This study was partly supported by a Grant for Child Health and Development (16-c3) from the Ministry of Health, Labour and Welfare, and a research grant from Sapporo Bioscience Foundation.

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Authors and Affiliations

  1. Faculty of Advanced Techno-Surgery, Department of Advanced Biomedical Engineering and Science, Graduate School of Medical Science, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    G. Ogura, R. Nakamura, Y. Muragaki & H. Iseki

  2. ALOKA Co., Ltd, Tokyo, Japan

    G. Ogura

  3. Division of Artifical System Science, Graduate School of Engineering, Chiba University, Chiba, Japan

    R. Nakamura

  4. Department of Neurosurgery, Neurological Institute, Tokyo Women’s Medical University, Tokyo, Japan

    Y. Muragaki & H. Iseki

  5. Faculty of Medical Sciences, Department of Advanced Medical Initiatives, Kyushu University, Fukuoka, Japan

    M. Hashizume

Authors
  1. G. Ogura
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  2. R. Nakamura
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  3. Y. Muragaki
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  4. M. Hashizume
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  5. H. Iseki
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Corresponding author

Correspondence to R. Nakamura.

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Ogura, G., Nakamura, R., Muragaki, Y. et al. Development of an articulating ultrasonically activated device for laparoscopic surgery. Surg Endosc 23, 2138–2142 (2009). https://doi.org/10.1007/s00464-008-0248-7

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  • DOI: https://doi.org/10.1007/s00464-008-0248-7

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