Holmium:YAG laser-induced liquid jet dissector: a novel prototype device for dissecting organs without impairing vessels.
OBJECTIVE
Neurosurgery has long required a method for dissecting brain tissue without damaging principal vessels and adjacent tissue, so as to prevent neurological complications after operation. In this study we fabricated such a prototype device and used it in an attempt to resect an animal liver, which, like the brain, contains many vessels.


METHODS
The prototype device consisted of a jet nozzle and a suction tube. Pulsed liquid jets at 3 Hz were ejected from the nozzle by a pulsed holmium:YAG (Ho:YAG) laser at an irradiation energy of 230 mJ/pulse. The profile of the liquid jet was observed with a high-speed camera. With this device, liver dissections of anesthetized rabbits were attempted while measuring the local temperature of the target. A histological study of the incised parts was also performed.


RESULTS
The liquid jet was emitted straight from the nozzle at an initial velocity of 38 m/sec. The liver parenchyma was cut with the device while preserving the tiny vessels and keeping the operative field clear. The local temperature rose to no more than 314 K (below the heat damage threshold of brain tissue). In the histological findings, there were no signs of hepatic degeneration or necrosis around the dissected margin.


CONCLUSIONS
The Ho:YAG laser-induced liquid jet dissector can be applied to neurosurgical operations after incorporating some minor improvements.
Hirano
T
T
Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan. taka1789@aol.com
Uenohara
H
H
Komatsu
M
M
Nakagawa
A
A
Satoh
M
M
Ohyama
H
H
Takayama
K
K
Yoshimoto
T
T
D000818:Animals; D001927:Brain Diseases / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000295:instrumentation*; D004867:Equipment Design; D053685:Laser Therapy / Q000295:instrumentation*; D008099:Liver / Q000473:pathology / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D019635:Neurosurgical Procedures / Q000295:instrumentation*; D011817:Rabbits