Chang Wesley C, Hawkes Elizabeth A, Kliot Michel, Sretavan David W
Department of Ophthalmology, University of California, San Francisco, California 94143, USA.
Neurosurgery. 2007 Oct;61(4):683-91; discussion 691-2. doi: 10.1227/01.NEU.0000298896.31355.80.
Microfabricated devices with nanoscale features have been proposed as new microinstrumentation for cellular and subcellular surgical procedures, but their effectiveness in vivo has yet to be demonstrated. In this study, we examined the in vivo use of 10 to 100 microm-long nanoknives with cutting edges of 20 nm in radius of curvature during peripheral nerve surgery.
Peripheral nerves from anesthetized mice were isolated on a rudimentary microplatform with stimulation microelectrodes, and the nanoknives were positioned by a standard micromanipulator. The surgical field was viewed through a research microscope system with brightfield and fluorescence capabilities.
Using this assembly, the nanoknife effectively made small, 50 to 100 microm-long incisions in nerve tissue in vivo. This microfabricated device was also robust enough to make repeated incisions to progressively pare down the nerve as documented visually and by the accompanying incremental diminution of evoked motor responses recorded from target muscle. Furthermore, this nanoknife also enabled the surgeon to perform procedures at an unprecedented small scale such as the cutting and isolation of a small segment from a single constituent axon in a peripheral nerve in vivo. Lastly, the nanoknife material (silicon nitride) did not elicit any acute neurotoxicity as evidenced by the robust growth of axons and neurons on this material in vitro.
Together, these demonstrations support the concept that microdevices deployed in a neurosurgical environment in vivo can enable novel procedures at an unprecedented small scale. These devices are potentially the vanguard of a new family of microscale instrumentation that can extend surgical procedures down to the cellular scale and beyond.
具有纳米级特征的微制造设备已被提议作为用于细胞和亚细胞外科手术的新型微仪器,但它们在体内的有效性尚未得到证实。在本研究中,我们研究了在周围神经手术中使用曲率半径为20 nm的10至100微米长的纳米刀。
在带有刺激微电极的简易微平台上分离麻醉小鼠的周围神经,并用标准显微操作器定位纳米刀。通过具有明场和荧光功能的研究显微镜系统观察手术区域。
使用该组件,纳米刀在体内能有效地在神经组织中制造出50至100微米长的小切口。这种微制造设备也足够坚固,能够进行重复切口,以逐渐削减神经,这在视觉上以及从目标肌肉记录的诱发运动反应的伴随增量减少中都有记录。此外,这种纳米刀还使外科医生能够以前所未有的小规模进行手术,例如在体内从周围神经的单个组成轴突中切割和分离一小段。最后,纳米刀材料(氮化硅)未引发任何急性神经毒性,体外轴突和神经元在该材料上的强劲生长证明了这一点。
总之,这些证明支持了这样一种概念,即在体内神经外科环境中部署的微型设备能够以前所未有的小规模实现新颖的手术。这些设备可能是新的微型仪器家族的先锋,能够将外科手术扩展到细胞尺度及更微观的尺度。