title: First experimental results with a new waterjet dissector: Erbejet 2.
abstract: BACKGROUND
  Waterjet dissection represents a useful technique for many surgical procedures. In this experimental study, the technical features and dissection qualities of the new Erbejet 2 with its new pump and nozzle applicator system are evaluated for its neurosurgical use compared to the established Helix Hydro-Jet.
  
  
  METHODS
  One hundred twenty-six fresh cadaveric pig brains were simultaneously cut with the Helix Hydro-Jet and Erbejet 2. Different pressure levels were applied to cerebral tissue with and without meninges, cerebellum and brainstem. Additionally, dissection characteristics of various cutting media were investigated.
  
  
  RESULTS
  There was a nearly equal dissection quality at up to 10 bar of both instruments. In contrast to the Helix Hydro-Jet, Erbejet 2 application at higher pressures resulted in an almost linear increase of dissection depth with a small standard deviation. Smoother cutting margins and less foaming were found. Preserved vessels were observed with both devices. Hydroxyaethyl starch led, in contrast to Ringer's solution and isotonic saline solution, to increased dissection width and more foaming.
  
  
  CONCLUSIONS
  The new Erbejet 2 is more precise, with almost linear correlation of pressure and dissection depth compared to the Helix Hydro-Jet. Less foaming and the possible application of various separating media are a considerable advantage. All things considered, the new Erbejet 2 offers more options to enlarge the field of neurosurgical indications for waterjet dissection.
authors.affiliation: Department of Neurosurgery, Hanover Medical School, Hanover, Germany.
authors.forename: C A
authors.initials: CA
authors.lastname: Tschan
authors.forename: K
authors.initials: K
authors.lastname: Tschan
authors.forename: J K
authors.initials: JK
authors.lastname: Krauss
authors.forename: J
authors.initials: J
authors.lastname: Oertel
mesh_terms: D000818:Animals; D001921:Brain / Q000033:anatomy & histology / Q000601:surgery*; D002536:Cerebral Arteries / Q000033:anatomy & histology / Q000601:surgery; D004210:Dissection / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design / Q000379:methods; D006874:Hydrostatic Pressure; D007431:Intraoperative Complications / Q000517:prevention & control; D007552:Isotonic Solutions / Q000008:administration & dosage; D023421:Models, Animal; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods*; D000077331:Ringer's Solution; D012965:Sodium Chloride / Q000008:administration & dosage; D013525:Surgical Instruments / Q000639:trends*; D034421:Sus scrofa; D014867:Water
chemical_list: D007552:Isotonic Solutions; D014867:Water; D012965:Sodium Chloride; D000077331:Ringer's Solution