Вестник медицинского института «Реавиз»: Реабилитация, врач и здоровье (Jun 2024)
Thermocoagulation of resection surfaces of parenchymal organs using a new source of ultrahigh frequency energy (experimental study)
Abstract
Relevance. Modern surgery is characterized by the use of various technical means to perform classical surgical techniques - separation and connection of tissues, hemostasis. The study of the applicability of new surgical devices and the search for technological techniques are an important task.The aim of the study: to evaluate the capabilities of the developed device based on microwave energy for hemostatic coagulation of resection surfaces of parenchymal organs.Materials and methods. The method is based on the principle of converting microwave energy into heat when it is absorbed in biological tissue. The choice of the microwave range is due to the higher efficiency of power supply to the heating area. Based on the prototype of a medical microwave complex developed in 2011 for thermal effects on biological tissues (RF Patent 2481080. 2011), a prototype of a microwave coagulator for working with parenchymal organs was created. The device was tested on the parenchymal organs of large laboratory animals under conditions of preserved and switched off blood flow in various energy supply modes. Tissue samples from coagulated lesions were studied histologically.Results. At the site of exposure of the applicator-coagulator to the parenchymal organ, a zone of coagulation changes appears. A clear dependence of the size of coagulation necrosis on the time and power of exposure was noted. When the blood flow is turned off, the necessary stable hemostasis is achieved by shorter exposure time of the coagulator antenna on the surface of the organ.Conclusions. The most effective and reliable hemostasis is achieved on the liver parenchyma. The use of temporary vascular isolation, especially on the kidneys and spleen, involves a single use of microwave energy to stop bleeding. By changing the power and duration of exposure, it is possible to dose the thermal load on biological tissue with great precision. This adjustment allows you to select the operating mode for each specific case. The obtained results of the experiment of the described system during surgery for the purpose of hemostasis in parenchymal bleeding.
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