脊椎内視鏡手術に対する超音波切開凝固システムの臨床応用

Clinical Study of the Ultrasonically Activated Scalpel for Endoscopic Spine Surgery

　脊椎内視鏡手術にハーモニック・スカルペルを用いることにより，電気メスでみられる煙を吸って視野を確保する必要がなく，また従来のCUSA®と異なり切開が可能となった．そのメカニズムは，50〜100μmの振幅で毎秒55,500回ブレードを振動させることによるコアギュラムの生成にある．したがって，コラーゲンに富んだ神経の損傷はないので脊髄神経根周囲の手術に有用と考える．

The ultrasonically activated scalpel for endoscopic spine surgery can cut and coagulate tissue without the generation of smoke. When using this scalpel, the visual field is obscured less by smoke during endoscopic spine surgery compared with aspirating the accumulated smoke during electrosurgery. The cutting mecha-nism for the ultrasonically activated scalpel is different from that observed with electrosurgery or laser surgery. The cutting power is by a relatively sharp blade vibrating 55,500 times per second over distance of 50-100 μm The ultrasonically activated scalpel is safe tool to manipulate the nervous tissue.