新型低温等离子手术系统(NTS-100)的猪肝脾切割实验评价

Experimental evaluation of a novel low temperature plasma surgical system on porcine liver and spleen

  • 摘要: 目的 评价一种新型低温等离子手术系统(NTS-100)在肝、脾等富血供器官手术中的有效性和安全性。 方法 12头巴马小型猪随机分为3组,比较新型低温等离子手术系统(NTS-100)、高频电刀(Valley)、低温等离子手术刀(PEAK)在肝脾切割、凝血、热损伤等方面的差异,评价指标包括局部工作温度、出血量、组织凝固坏死区域、手术流畅性等。 结果 在肝切割实验中,3种电外科设备的出血量差异无统计学意义(P> 0.05)。在脾切割实验中,切割模式下3组设备的出血量差异无统计学意义(P> 0.05)。凝血模式下新型低温等离子手术系统的出血量明显少于高频电刀(0.762±0.290) g vs (1.170±0.364) g,P< 0.05和低温等离子手术刀(0.762±0.290)g vs (1.233±0.454) g,P< 0.05。新型低温等离子手术系统的局部工作温度显著低于高频电刀肝切割(75.3±6.1)℃ vs (204.6±20.5)℃,肝凝血(195.8±15.4)℃ vs (272.3±26.6)℃,脾切割(69.4±11.1)℃ vs (226.8±30.0)℃,脾凝血(199.8±16.9)℃ vs (267.8±42.5)℃,P均< 0.01,但与低温等离子手术刀差异无统计学意义(P> 0.05)。新型低温等离子手术系统对肝脾组织的急性热损伤宽度小于高频电刀(P< 0.05),与低温等离子手术刀比较,无统计学差异(P> 0.05)。新型低温等离子手术系统对肝脾组织的切割锋利度优于高频电刀和低温等离子手术刀,焦痂形成少,且易脱落。 结论 新型低温等离子手术系统的局部工作温度较高频电刀大幅度下降,与低温等离子手术刀相当;对肝脾等血供丰富的组织的凝血效果优于低温等离子刀及高频电刀;对软组织切割的锋利度优于高频电刀和低温等离子手术刀,手术流畅性佳。

     

    Abstract: Objective To evaluate effectiveness and safety of a new surgical system which applies low temperature plasma (NTS-100) in the liver and spleen surgeries. Methods Twelve piglets were randomly divided into three groups, and they underwent operations using NTS-100, Valley or PEAK surgical systems, respectively. The advantages and disadvantages of these three devices in terms of cutting, coagulation, thermal injury necrosis were evaluated with the indexes of local working temperature, blood loss, region of coagulation necrosis, operation fluency. Results There was no statistically significant difference in the amount of bleeding among three electrosurgical devices in liver surgeries (P> 0.05). In spleen surgeries, the amount of bleeding produced by NTS-100 coagulation mode was statistically significantly less than those by the Valley and PEAK (0.762±0.290) g vs (1.170±0.364) g, (1.233±0.454) g, P< 0.05, respectively, however, in the cutting mode, there was no statistically significant difference (P> 0.05). The local temperatures of liver and spleen in the cut and coagulation mode of NTS-100 were statistically significantly lower than those of Valley temperature as liver cutting: (75.3±6.1)℃ vs (204.6±20.5)℃; temperature as liver coagulated: (195.8±15.4)℃vs (272.3±26.6)℃; temperature as spleen cutting: (69.4±11.1)℃ vs (226.8±30.0)℃; temperature as spleen coagulated: (199.8± 16.9)℃ vs (267.8±42.5)℃, P< 0.01, respectively, and it was also lower than that of PEAK with no statistically significant difference (P> 0.05). The width of acute heat injury by NTS-100 to liver and spleen was statistically significantly less than that of Valley (P< 0.05), but not different with PEAK (P> 0.05). The cutting sharpness of NTS-100 to soft tissue was superior to Valley and PEAK. The scab adhered to NTS-100 was less and it was easier to fall off than Valley. Conclusion Local working temperature of this new surgical system which applies low temperature plasma (NTS-100) is significantly lower than Valley, and comparable with PEAK. The coagulation effect to liver and spleen as using NTS-100 is better than PEAK and Valley. The sharpness to soft tissue as using NTS-100 is greater than PEAK and Valley, and the operation fluency is also better as using NTS-100.

     

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