Taniguchi Daisuke, Matsumoto Keitaro, Kondo Yoshihiro, Shimoyama Koichiro, Hashimoto Yasumasa, Elgalad Abdelmotagaly, Obata Tomohiro, Miyazaki Takuro, Tsuchiya Tomoshi, Matsuo Naoto, Lawn Murray John, Yamasaki Naoya, Yamamoto Ikuo, Nagayasu Takeshi
1 Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Japan.
2 Medical-Engineering Hybrid Professional Development Center, Nagasaki University Graduate School of Biomedical Sciences, Japan.
Surg Innov. 2018 Oct;25(5):435-443. doi: 10.1177/1553350618784473. Epub 2018 Jul 2.
In recent years, video-assisted thoracoscopic surgery (VATS) has increasingly become the preferred technique for thoracic surgery. However, the inherent characteristics of the lungs as large, soft, slippery, and delicate creates difficulties for pulmonary surgery. In this article, we outline the development and assessment of a balloon-based organ retractor for VATS via collaboration between medical and engineering personnel.
A dry lab trial and accompanying questionnaire assessment were performed by a group of thoracic surgeons. Objective pressure measurements were obtained, and animal experiment on pigs was performed.
In the dry lab trial, use of the developed organ retractor required significantly less time and resulted in fewer difficulties than using a Cherry Dissector. The measured pressure per mm of the developed retractor was clearly lower than that for the Cherry Dissector. The questionnaire completed by the surgeons following the dry lab and animal experiments showed that most of the surgeons (7 surgeons out of 9) were satisfied with the quality of the balloon-based retractor based on a score of 3.13 ± 0.28 (mean ± standard deviation) out of 4.0. During the animal experiment, the balloon-based retractor provided stable and clear viewing with minimal need for adjustment.
This balloon-based retractor could contribute to increased safety and less-invasive VATS.
近年来,电视辅助胸腔镜手术(VATS)越来越成为胸外科手术的首选技术。然而,肺脏大、软、滑且脆弱的固有特性给肺部手术带来了困难。在本文中,我们概述了通过医学和工程人员合作开发和评估一种用于VATS的基于球囊的器官牵开器。
一组胸外科医生进行了干式实验室试验及随附的问卷调查评估。获得了客观压力测量值,并在猪身上进行了动物实验。
在干式实验室试验中,与使用樱桃解剖器相比,使用开发的器官牵开器所需时间显著更少,困难也更少。所开发牵开器每毫米的测量压力明显低于樱桃解剖器。胸外科医生在干式实验室试验和动物实验后填写的问卷显示,大多数外科医生(9名中的7名)对基于球囊的牵开器质量感到满意,评分为3.13±0.28(均值±标准差)(满分4.0)。在动物实验期间,基于球囊的牵开器提供了稳定且清晰的视野,几乎无需调整。
这种基于球囊的牵开器有助于提高VATS的安全性并减少侵入性。