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

Atsuhiro Nakagawa; Toshiki Endo; Tomohiro Kawaguchi; Masato Yamada; Chiaki Sato; Toshihiro Kumabe; Masaki Iwasaki; Kuniyasu Niizuma; Masayuki Kanamori; Chikashi Nakanishi; Shinichi Yamashita; Toru Nakano; Teiji Tominaga

doi:10.1055/a-1962-1345

Journal of Neurological Surgery Part A: Central European Neurosurgery, Table of Contents

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

¹Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan

²Department of Biodesign, Clinical Research, Innovation, Education Center, Tohoku University Hospital, Sendai, Japan

,

Toshiki Endo

³Department of Neurosurgery, Tohoku University, Aoba, Sendai, Japan

⁴Department of Neurosurgery, Kohnan Hospital Ringgold Standard Institution, Sendai, Miyagi, Japan

,

Tomohiro Kawaguchi

¹Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan

,

Masato Yamada

⁵Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine Ringgold Standard Institution, Sendai, Miyagi, Japan

,

Chiaki Sato

⁵Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine Ringgold Standard Institution, Sendai, Miyagi, Japan

,

Toshihiro Kumabe

⁶Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Japan

,

Masaki Iwasaki

⁷Department of Neurosurgery, National Center of Neurology and Psychiatry Ringgold Standard Institution, Kodaira, Japan

,

Kuniyasu Niizuma

¹Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan

⁸Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan

⁹Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan

,

Masayuki Kanamori

¹Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan

,

Chikashi Nakanishi

⁵Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine Ringgold Standard Institution, Sendai, Miyagi, Japan

,

Shinichi Yamashita

¹⁰Department of Urology, Tohoku University Graduate School of Medicine Ringgold Standard Institution, Sendai, Miyagi, Japan

,

Toru Nakano

¹¹Division of Gastroenterology and Hepatobiliary Pancreatic Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan

,

Teiji Tominaga

¹Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan

› Author Affiliations

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

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References

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