Abstract
Background Pulsed water jet dissection is an emerging surgical method for achieving maximal resection of a lesion and postoperative function preservation. We aimed to clarify liver damage and long-term results after liver resection using a novel surgical device, piezo actuator-driven pulsed water jet (ADPJ), in a rat model.Methods We categorizedSprague–Dawley rats into four groups and subjected themto sham operation or liver resection using an ADPJ, an ultrasonic aspirator (UA), or a radio knife. At 1, 3, 7, 14, 28, and 56 days postoperatively, we euthanizedfive rats from each group after collecting blood samples and harvested residual livers.We measured serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and glutamate dehydrogenase (GLDH) concentrations. Morphological characteristics and resection surfaces were assessed by hematoxylin–eosin staining.ResultsOn day 1, serum AST and ALT levels were significantly lower with an ADPJ than with an UA and a radio knife (AST: ADPJ vs. UA, P<0.05, ADPJ vs. radio knife, P<0.01; ALT: ADPJ vs. UA, P<0.05, ADPJ vs. radio knife, P<0.01). GLDH levels on day 1 were significantly lower with an ADPJ than with other devices (ADPJ vs. UA, P<0.05; ADPJ vs. radio knife, P<0.01).Degree of degeneration from the resection surface was mild with an ADPJ. Number of rats in which denaturation completely disappeared was significantly more withan ADPJ than with other devices on day 28 (ADPJ vs. UA, P<0.05; ADPJ vs. radio knife, P<0.01).ConclusionsLiver damage afterliver resection was markedly less with an ADPJ than with an UA or a radio knife. Furthermore, the liver recovered faster after an ADPJ.
The Piezo Actuator-Driven Pulsed Water Jet System for Minimizing Renal Damage after Off-Clamp Laparoscopic Partial Nephrectomy
