超音波凝固切開装置のキャビテーションによる生体傷害作用の検討

Analysis of tissue damage caused by ultrasonically activated device

◆要旨：超音波凝固切開装置が発生するいわゆる“キャビテーション”には強力な組織傷害作用があると考えられる．同装置の安全な使用方法を明らかにするため，生体組織に傷害をきたすエネルギーレベルのキャビテーションの発生様式を，ブタの生体組織を用いた解析により検討した．ブタ小腸と超音波凝固切開装置のブレード先端との距離をさまざまに変化させて装置をアクティベートし，その後，標本の組織学的検討を行った．0.3mm以上離した状態では異常所見を認めず，0.1mmでは漿膜下層まで，接触した状態で初めて筋層に至る傷害が観察された．超音波凝固切開装置の組織傷害性を示す“キャビテーション”はブレード先端のきわめて近傍にしか発生していないものと考えられた．

　In order to determine the safe usage of ultrasonically activated devices（USAD）, extent of spreading the biologically harmful“cavitation”from USAD was measured by using the porcine gut. Small intestine was pulled out from 3-month-old domestic pigs under general anesthesia. USAD was activated under several settings, varying the distances between the serosa of the intestine and the tip of the blade. No histological damages were observed on the specimens where the distance between the intestinal serosa and the blade was 0.3 mm or more. However, damages to subserosa and musclaris propria were observed for those specimens with the distance of 0.1 mm and in contact with the serosa. These data suggested that no harmful effect would be expected as long as the blade is apparently apart from the target organs.