Bischof J C, Merry N, Hulbert J
Department of Mechanical Engineering, University of Minnesota, Minneapolis, USA.
Cryobiology. 1997 Feb;34(1):80-92. doi: 10.1006/cryo.1996.1987.
This study presents the design and characterization of an insulating probe made of silicone that could be used for enhancing the safety and efficacy of prostate cryosurgery. The probe would be placed in Denonvilliers' fascia between the prostate and the rectum prior to freezing. During freezing, the iceball would be monitored by ultrasound through the silicone, and direct temperature monitoring of the rectal and prostatic tissue via thermocouples mounted on opposing sides of the device. Both theoretical and experimental studies were performed to verify the insulating and acoustic properties of the probe. The insulating effect of the silicone will enhance cell death within the prostate while minimizing tissue freezing injury and therefore fistula formation postfreeze in the rectum. Experiments were also performed with the insulator placed in gelatine which showed that the silicone material is transparent to ultrasound. In addition the silicone was itself visible under ultrasound imaging, a characteristic which may assist in the delivery of the device to the surgical site. One possible scenario for reconfiguration and delivery of the device is suggested prior to a cryosurgery. The success of this device in insulating and monitoring temperature during freezing suggests that it can also be useful in protecting sensitive tissues adjacent to a surgical site when extreme heat is applied (i.e., electron or hyperthermic surgery).
本研究介绍了一种由硅树脂制成的绝缘探针的设计与特性，该探针可用于提高前列腺冷冻手术的安全性和有效性。在冷冻前，该探针将放置在前列腺和直肠之间的 Denonvilliers 筋膜中。在冷冻过程中，可通过硅树脂用超声监测冰球，并通过安装在设备相对两侧的热电偶对直肠和前列腺组织进行直接温度监测。进行了理论和实验研究以验证该探针的绝缘和声学特性。硅树脂的绝缘效果将增强前列腺内的细胞死亡，同时将组织冷冻损伤降至最低，从而减少冷冻后直肠瘘的形成。还将绝缘体置于明胶中进行了实验，结果表明硅树脂材料对超声是透明的。此外，硅树脂本身在超声成像下可见，这一特性可能有助于将设备输送到手术部位。在冷冻手术前，提出了一种设备重新配置和输送的可能方案。该设备在冷冻过程中的绝缘和温度监测方面的成功表明，在应用极端热量（即电子或热疗手术）时，它也可用于保护手术部位附近的敏感组织。
