消化内镜下新型双极电刀的安全有效性动物实验评估
作者:
作者单位:

1.中国科学院大学附属肿瘤医院内镜中心;2.杭州安杰思医学科技有限公司

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基金项目:

浙江省科技厅重点研发计划(2019C03062)


Assessment for the efficiency and safety of a novel bipolar electric knife used in digestive endoscopy in an animal model
Author:
Affiliation:

Department of Endoscopy, Cancer Hospial of the University of Chinese Academy of Sciences

Fund Project:

Key Research and Development Project from the Ministry of Science and Technology of Zhejiang Province (2019C03062)

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    摘要:

    目的 探讨一款消化内镜下新型双极电刀进行内镜黏膜下剥离术的安全性及有效性。方法 通过有限元分析方法对比新型双极电刀与传统单极电刀对肌肉组织热损伤区域的差异。离体动物实验分析二者对猪胃壁的纵向热损伤距离。活体动物实验比较二者行猪消化道黏膜下剥离术的整块切除率、切割效率等指标。结果 有限元模型表明,排除个体差异、手术操作因素的影响后,单极刀对肌肉组织热损伤区域的长、宽、深分别为双极刀的1.08倍、1.12倍和1.23倍。离体动物实验表明,相同功率下通电1 s,双极刀对猪胃壁的的纵向热损伤距离为(433.25±42.58)μm,小于单极刀的(898.03±111.59)μm(t=6.740,P=0.003)。活体动物实验中,两种电刀系统的黏膜整块切除率均是100.0%。双极刀的切割创面为(229.58±185.29)mm2,所用切割时间为(164.37±96.27)s,单极刀的切割创面为(209.70±167.35)mm2,所用切割时间为(162.65±69.97)s,差异均无统计学意义(P>0.05)。结论 该新型双极电刀在模拟实验和动物实验中安全有效,尚需临床消化道手术的进一步证实。

    Abstract:

    Objective To explore the safety and efficiency of a novel bipolar electric knife for endoscopic submucosal dissection. Methods The thermal damage on tissue caused by the new bipolar knife and traditional monopolar knife were compared by finite element analysis. The vertical thermal damage to the porcine gastric wall caused by the two types of electric knife were analyzed in vitro animal experiments. In vivo animal experiments were used to compare operation related indexes of two types of electric knife, including en bloc resection rate and cutting efficiency in porcine digestive tract submucosal dissection. Results Through overcoming deviation of experimental individuals and operator experience, the finite element model showed that the length, width and depth of thermal damage on tissue caused by the monopolar knife was 1.08 times, 1.12 times, and 1.23 times of that of the bipolar knife, respectively. Additionally, the bipolar knife caused less vertical thermal damage to the porcine gastric wall than the monopolar knife (433.25±42.58 μm VS 898.03±111.59 μm, t=6.740, P=0.003) in vitro animal experiments when charged for 1 s at the same power. Finally, in vivo animal experiments showed that the en bloc resection rates of the two kinds of electric knife systems were both 100.0%. In addition, the cutting area and cutting time of the bipolar knife was 229.58±185.29 mm2 and 164.37±96.27 s, respectively. The corresponding indicators of the monopolar knife was 209.70±167.35 mm2 and 162.65±69.97 s, respectively, and there was no significant difference (all P>0.05). Conclusion The novel bipolar knife not only ensures the cutting efficiency but also reduces the thermal damage during endoscopic submucosal dissection in simulating experiment and animal experiment, which needs further verification in clinical trial.

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周丹萍,刘元顺,李焱冬,等.消化内镜下新型双极电刀的安全有效性动物实验评估[J].中华消化内镜杂志,2020,37(5):341-347.

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  • 收稿日期:2019-11-12
  • 最后修改日期:2020-04-03
  • 录用日期:2020-02-26
  • 在线发布日期: 2020-05-22
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