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J Neurol Surg A Cent Eur Neurosurg 2025; 86(02): 205-212
DOI: 10.1055/a-1962-1345
Technical Note

Piezoelectric Actuator-Driven Pulsed Water Jet for Neurosurgery: Laboratory Evaluation with the Swine Model and Implications of Mechanical Properties

Atsuhiro Nakagawa
1   Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
2   Department of Biodesign, Clinical Research, Innovation, Education Center, Tohoku University Hospital, Sendai, Japan
,
Toshiki Endo
3   Department of Neurosurgery, Tohoku University, Aoba, Sendai, Japan
4   Department of Neurosurgery, Kohnan Hospital Ringgold Standard Institution, Sendai, Miyagi, Japan
,
Tomohiro Kawaguchi
1   Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
,
Masato Yamada
5   Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine Ringgold Standard Institution, Sendai, Miyagi, Japan
,
Chiaki Sato
5   Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine Ringgold Standard Institution, Sendai, Miyagi, Japan
,
Toshihiro Kumabe
6   Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Japan
,
Masaki Iwasaki
7   Department of Neurosurgery, National Center of Neurology and Psychiatry Ringgold Standard Institution, Kodaira, Japan
,
Kuniyasu Niizuma
1   Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
8   Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
9   Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
,
Masayuki Kanamori
1   Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
,
Chikashi Nakanishi
5   Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine Ringgold Standard Institution, Sendai, Miyagi, Japan
,
Shinichi Yamashita
10   Department of Urology, Tohoku University Graduate School of Medicine Ringgold Standard Institution, Sendai, Miyagi, Japan
,
Toru Nakano
11   Division of Gastroenterology and Hepatobiliary Pancreatic Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
,
Teiji Tominaga
1   Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
› Author Affiliations
Funding This work was supported in part by a Grant-in-Aid for Scientific Research (B) (No. 18390388 to TT), Grants-in-Aid for Young Scientists (A) (Nos. 19689030 and 22689039 to AN), and Challenging Exploratory Research (No. 21659313 to AN and No. 25670565 to TN and AN) from the Japanese Ministry of Education, Culture, Sports, Science, and Technology, the Japanese Foundation for Research and Promotion of Endoscopy Grant (to TN and AN), the Tohoku University Exploratory Research Program for Young Scientists (to AN), the Collaborative Research Project of the Institute of Fluid Science, Tohoku University (to AN), and Ogino Award from the Japanese Society for Medical and Biomedical Engineering (to AN).The piezoelectric ADPJ system was supplied by Seiko Epson Corporation (Suwa, Nagano, Japan). The authors otherwise report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
› Further Information
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Abstract

Background Pulsed water jet is an emerging surgical instrumentation intended to achieve both maximal lesion resection and functional maintenance through preservation of fine vessels and minimal damage to the surrounding tissue. The piezoelectric actuator-driven pulsed water jet (ADPJ) is a new technology that can deliver a precisely controlled uniform and efficient pulsed water jet with minimum water flow. The present study evaluated the ADPJ system in preclinical animal studies in the swine brain, and investigated breaking strength, one of the parameters for mechanical properties, to elucidate the mechanism of tissue selectivity for tissue dissection by the water jet.

Methods This system consisted of a pump chamber driven by a piezoelectric actuator, a stainless steel tube, and a nozzle (internal diameter: 0.15 mm). Water was supplied at 6 ml/min. The relationship between input voltage (3–25 V at 400 Hz) and peak pressure was measured using a pressure sensor through a sensing hole. The temporal profile of dissection depth during moving application was evaluated using gelatin brain phantom and swine brain. The dissected specimens were evaluated histologically. The mechanical property (breaking strength) of the swine brain was measured by a compact table-top universal tester.

Results Peak pressure increased linearly with increase in input voltage, which reflected the dissection depth in both the gelatin brain phantom and swine brain. Small arteries were preserved, and minimum damage to surrounding tissues occurred. The breaking strength of the arachnoid membrane (0.12 ± 0.014 MPa) was significantly higher compared with the gray matter (0.030 ± 0.010 MPa) and white matter (0.056 ± 0.009 MPa; p < 0.05). The breaking strength of the gray matter corresponded to that of 3 wt% gelatin, and that of white matter corresponded to a value between 3.5 and 4 wt% gelatin, and the dissection depth seemed to be estimated at 3 to 4 wt% gelatin.

Conclusion The present study suggests that the ADPJ system has the potential to achieve accurate tissue dissection with preservation of blood vessels in neurosurgery. The difference in breaking strength may explain the tissue selectivity between the brain parenchyma and tissue protected by the arachnoid membrane.

Keywords

functional preservation - maximal lesion removal - minimally invasive surgery - medical engineering - water jet


Publication History

Received: 19 June 2022

Accepted: 14 October 2022

Accepted Manuscript online:
17 October 2022

Article published online:
08 November 2024

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