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新型直肠/子宫夹持器的研制。

Development of novel rectal/uterine clamping device.

机构信息

Department of Next Generation Endoscopic Intervention (Project ENGINE), Osaka University Graduate School of Medicine, Suite 0802, BioSystems Bldg., 1-3, Yamadaoka, Osaka, 565-0871, Osaka, Japan.

Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.

出版信息

Sci Rep. 2024 Oct 3;14(1):22960. doi: 10.1038/s41598-024-75103-y.

DOI:10.1038/s41598-024-75103-y
PMID:39362951
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11450202/
Abstract

We developed a novel clamping device for laparoscopic surgery, free from conventional pinch structure, capable of uniformly occluding any ductal organ. This study aimed to evaluate performance of the new clamper compared to the pinch-type clamper. The new clamper consists of two metal bars with ties at each end, which enables parallel clamping. A resected porcine stomach was used, with an infusion tube at the anal end to increase intra-luminal pressure. The oral side of the stomach was clamped with either the new clamper or the pinch-type clamper, and their performances were evaluated in qualitative and semi-quantitative manner. Qualitative evaluation involved imaging the clamping site at intra-gastric pressures from 0 to 15 mmHg using microfocus computed tomography. The new clamper showed no gap even under increased intra-luminal pressure, while the pinch-type clamper showed a gap on the distal side. Quantitative evaluation measured bursting pressure under continuous air insufflation. Air leakages were observed in the new clamper at higher intra-luminal pressures than in the pinch-type clamper (46.1 mmHg vs. 13.6 mmHg, P < 0.01). Our new clamping device showed superior performance in preclinical setting compared to the conventional pinch-type clamper. We are currently working on its design freezing and aiming for early commercialization.

摘要

我们开发了一种新型的腹腔镜手术夹持器,它摆脱了传统的夹持结构,能够均匀地夹住任何管状器官。本研究旨在评估新型夹持器与传统夹持器的性能。新型夹持器由两条金属棒组成,两端都有带子,可实现平行夹持。使用切除的猪胃,在肛门端有一根输液管以增加管腔内压力。胃的口腔侧用新型夹持器或传统夹持器进行夹持,并对其进行定性和半定量评估。定性评估包括使用微焦点计算机断层扫描在 0 至 15 mmHg 的胃内压力下对夹持部位进行成像。即使在增加的管腔内压力下,新型夹持器也没有间隙,而传统夹持器在远端有间隙。定量评估在持续空气注入下测量破裂压力。新型夹持器在更高的管腔内压力下发生空气泄漏,而传统夹持器没有(46.1 mmHg 比 13.6 mmHg,P<0.01)。与传统的夹持器相比,我们的新型夹持器在临床前环境中表现出更好的性能。我们目前正在对其进行设计冻结,并致力于早日商业化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754a/11450202/66bc7e43e87f/41598_2024_75103_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754a/11450202/e6f36e556e5d/41598_2024_75103_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754a/11450202/f6009bdb4de0/41598_2024_75103_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754a/11450202/b436b0fd9f4c/41598_2024_75103_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754a/11450202/9a9ee726edfb/41598_2024_75103_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754a/11450202/f0ca9e32f99e/41598_2024_75103_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754a/11450202/66bc7e43e87f/41598_2024_75103_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754a/11450202/e6f36e556e5d/41598_2024_75103_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754a/11450202/f6009bdb4de0/41598_2024_75103_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754a/11450202/b436b0fd9f4c/41598_2024_75103_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754a/11450202/9a9ee726edfb/41598_2024_75103_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754a/11450202/f0ca9e32f99e/41598_2024_75103_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754a/11450202/66bc7e43e87f/41598_2024_75103_Fig6_HTML.jpg

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本文引用的文献

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Interdiscip Cardiovasc Thorac Surg. 2023 Sep 2;37(3). doi: 10.1093/icvts/ivad119.
2
Intracorporeal colpotomy using the Gutclamper as a novel clamping device to prevent tumor spillage during laparoscopic radical hysterectomy for cervical cancer.采用 Gutclamper 进行腹腔镜宫颈癌根治术中的经阴道闭孔内结扎术以防止肿瘤播散。
Asian J Endosc Surg. 2023 Jul;16(3):658-661. doi: 10.1111/ases.13191. Epub 2023 Apr 19.
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Impact of rectal washout on recurrence and survival after anterior resection for rectal cancer.
直肠冲洗对直肠癌前切除术后复发和生存的影响。
BJS Open. 2022 Nov 2;6(6). doi: 10.1093/bjsopen/zrac150.
4
Survival after minimally invasive radical hysterectomy without using uterine manipulator for early-stage cervical cancer: A systematic review and meta-analysis.早期宫颈癌行微创根治性子宫切除术且不使用子宫操纵器的生存情况:系统评价和荟萃分析。
BJOG. 2023 Jan;130(2):176-183. doi: 10.1111/1471-0528.17339. Epub 2022 Nov 13.
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Radical Hysterectomy After the LACC Trial: Back to Radical Vaginal Surgery.LACC 试验后行根治性子宫切除术:回归根治性阴道手术。
Curr Treat Options Oncol. 2022 Feb;23(2):227-239. doi: 10.1007/s11864-022-00937-5. Epub 2022 Feb 23.
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Total Laparoscopic Nerve-Sparing Radical Hysterectomy Using the No-look No-touch Technique.采用非直视非接触技术的全腹腔镜保留神经根治性子宫切除术。
Surg J (N Y). 2021 Oct 12;7(Suppl 2):S77-S83. doi: 10.1055/s-0041-1736178. eCollection 2021 Dec.
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