Research Group MITI, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Surg Endosc. 2009 Dec;23(12):2822-6. doi: 10.1007/s00464-009-0512-5. Epub 2009 May 23.
Ultrasound shears often are applied in minimally invasive surgery because they facilitate fast and secure tissue dissection, thereby reducing operative time. Although the technical principle underlying all the shears is almost identical, considerable differences exist between specific instruments. However, production of disturbing mist should be avoided.
To obtain quantitative measurements regarding mist production, a novel hermetically sealed test system was developed. Tissue dissection efficiency was evaluated by means of a standardized cutting test. The dissection time and the numbers of cuttings were recorded. In this study, four different ultrasound dissectors from three manufacturers were assessed. One manufacturer provided two instruments: a conventional instrument and an improved version, which was designed particularly to reduce mist emission.
The fastest ultrasound dissector emitted the highest quantity of disturbing mist. However, improved dissection efficiency does not linearly correlate with mist production. This clearly could be shown for the improved "less mist production instrument," which turned out to work faster than the comparable standard dissector but produced significantly less mist.
Ultrasonic shears are effective for bloodless tissue dissection but may impede surgical proceeding by mist production. The findings of this study demonstrate that emission of mist can be reduced not only by lowering the dissection power, resulting in a prolonged dissection time, but also by modifying the technical design of an instrument. Further development of ultrasonic cutting devices therefore should account for the desired results.
超声剪切器常用于微创手术，因为它们可以快速、安全地进行组织切割，从而缩短手术时间。尽管所有剪切器的技术原理几乎相同，但特定仪器之间存在很大差异。然而，应避免产生干扰性的雾气。
为了获得关于雾气产生的定量测量，开发了一种新颖的密封测试系统。通过标准化切割测试评估组织切割效率。记录切割时间和切割次数。在这项研究中，评估了来自三个制造商的四种不同的超声切割器。一个制造商提供了两种仪器：一种是传统仪器，另一种是改进版本，专门设计用于减少雾气排放。
最快的超声切割器产生的干扰雾气最多。然而，改进的切割效率与雾气产生并不呈线性相关。这一点在改进后的“减少雾气产生仪器”中表现得尤为明显，它的切割速度比可比的标准切割器快，但产生的雾气明显更少。
超声剪切器可有效用于无血组织切割，但雾气产生可能会妨碍手术进行。本研究的结果表明，不仅可以通过降低切割功率（导致切割时间延长）来减少雾气排放，还可以通过改进仪器的技术设计来减少雾气排放。因此，超声切割设备的进一步发展应考虑到所需的结果。
