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具有压力监测功能的双极电外科血管闭合装置。

Bipolar electrosurgical vessel-sealing device with compressive force monitoring.

作者信息

Chen Roland K, Chastagner Matthew W, Geiger James D, Shih Albert J

出版信息

J Biomech Eng. 2014 Jun;136(6):061001. doi: 10.1115/1.4027269.

Abstract

Bipolar electrosurgical vessel sealing is commonly used in surgery to perform hemostasis. The electrode compressive force is demonstrably an important factor affecting the vessel seal burst pressure, an index of the seal quality. Using a piezoresistive force sensor attached to the handle of a laparoscopic surgical device, applied handle force was measured and used to predict the electrosurgical vessel compressive force and the pressure at the electrode. The sensor enables the monitoring of vessel compressive force during surgery. Four levels of compressive force were applied to seal three types of porcine vessels (carotid artery, femoral artery, and jugular vein). The burst pressure of the vessel seal was tested to evaluate the seal quality. Compressive pressure was found to be a statistically significant factor affecting burst pressure for femoral arteries and jugular veins. Vessels sealed with low compressive pressure (<300 kPa) have a higher failure rate (burst pressure<100 mm Hg) than vessels sealed with high compressive pressure. An adequate compressive force is required to generate the compressive pressure needed to form a seal with high burst pressure. A laparoscopic surgical device with compressive force monitoring capability can help ensure adequate compressive pressure, vessel burst pressure, and quality of seal.

摘要

双极电外科血管封闭术在手术中常用于止血。电极压力显然是影响血管封闭破裂压力的一个重要因素,而血管封闭破裂压力是衡量封闭质量的一个指标。通过将一个压阻式力传感器连接到腹腔镜手术器械的手柄上,测量施加在手柄上的力,并用于预测电外科血管压力和电极处的压力。该传感器能够在手术过程中监测血管压力。对三种类型的猪血管(颈动脉、股动脉和颈静脉)施加四个压力水平进行封闭。测试血管封闭的破裂压力以评估封闭质量。发现压力是影响股动脉和颈静脉破裂压力的一个具有统计学意义的因素。与用高压力封闭的血管相比,用低压力(<300kPa)封闭的血管失败率更高(破裂压力<100mmHg)。需要足够的压力来产生形成具有高破裂压力的封闭所需的压缩压力。具有压力监测能力的腹腔镜手术器械有助于确保足够的压缩压力、血管破裂压力和封闭质量。

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