Application of pulsed water jet for tumor removal through transsphenoidal approach: Evaluation of nerve preservation

• Project/Area Number: 24592152
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cerebral neurosurgery
• Research Institution: Tohoku University
• Principal Investigator: OGAWA Yoshikazu 東北大学, 医学(系)研究科(研究院), 非常勤講師 (60606383)
• Co-Investigator(Kenkyū-buntansha): TOMINAGA Teiji 東北大学, 医学系研究科, 教授 (00217548) ; NAKAGAWA Atsuhiro 東北大学, 大学病院, 特任助教 (10447162) ; WASHIO Toshikatsu 独立行政法人産業技術総合研究所, 健康工学研究部門, 主任研究員 (40358370) ; ARAFUNE Tatsuhiko 東京電機大学, 理工学部, 助教 (50376597) ; OHTANI Kiyonobu 東北大学, 流体科学研究所, 助教 (80536748)
• Project Period (FY): 2012-04-01 – 2015-03-31
• Project Status: Completed (Fiscal Year 2014)
• Budget Amount: ¥5,330,000 (Direct Cost: ¥4,100,000、Indirect Cost: ¥1,230,000); Fiscal Year 2014: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2013: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2012: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000)
• Keywords: 低侵襲手術 / 医工学 / 破断強度 / 機能温存 / 流体工学 / 視覚誘発電位 / 脳神経外科 / 医療機器開発 / 産学連携 / 内視鏡 / 臨床研究 / トランスレーショナルリサーチ / 低侵襲治療 / ロボット手術 / 物性工学 / 下垂体

Outline of Final Research Achievements

Water jet technology provides tissue dissection with preservation of fine blood vessels. The purpose of present study is to evaluate functional preservation of peripheral nerves and dissection under intraoperative electrophysiological monitoring in patients with skull base tumors manifesting as severe visual disturbance through the extended transsphenoidal approach using pulsed laser-induced liquid jet (LILJ) system. Intraoperative visual evoked potential (VEP), and pre/postoperative conventional visual assessments were investigated. Precise dissections of the tumor were obtained, resulting in gross total removal. Most of the cases showed immediate improvement on intraoperative VEP and showed good recovery at discharge, and all patients evaluated had recovered good visual status. The LILJ system can achieve safe and optimal removal with functional preservation of optic nerves, probably because of the high resistance of the arachnoidal sheath and fine vascular tissue.

Research Products

• [Journal Article] Pulsed laser-induced liquid jet system for treatment of sellar and parasellar tumors: Initial experience in a multicenter clinical study (2014)
  • Author(s): Nakagawa A, Ogawa Y, Amano K, Ishii Y, Tahara S, Horiguchi K, Kawamata T, Yano S, Arafune T, Washio T, Kuratsu J, Saeki N, Okada Y, Teramoto A, Tominaga T
  • Journal Title: J Neurol Surg Volume: -
  • Peer Reviewed
• [Journal Article] レーザー誘発液体ジェットを用いた頭蓋底腫瘍摘出． 困難な脳神経外科手術―最近の進歩 (2014)
  • Author(s): 小川欣一、中川敦寛、冨永悌二
  • Journal Title: 先端医療 脳神経外科 Volume: -
  • Peer Reviewed
• [Journal Article] Mechanics of the injected pulsejet into gelatin gel and evaluation of the effect by puncture and crack generation and growth (2014)
  • Author(s): Kato T, Arafune T, Washio T, Nakagawa A, Ogawa Y, Tominaga T, Sakuma I, Kobayashi E
  • Journal Title: J Appl Phys 2014 Volume: -
  • Peer Reviewed
• [Journal Article] Measurement and analysis of internal stress distributions created in gelatin simulated-brain tissue by a pulsed laser-induced liquid jet (2014)
  • Author(s): Kato T, Arafune T, Washio T, Nakagawa A, Ogawa Y, Tominaga T, Sakuma I, Kobayashi E.
  • Journal Title: Proc. IEEE Volume: 2014 Pages: 4419-4421
  • Peer Reviewed
• [Journal Article] Pulsed laser-induced liquid jet: evolution from shock / bubble interaction to neurosurgical application (2014)
  • Author(s): Nakagawa A, Kumabe T, Ogawa Y, Hirano T, Nakano T, Watanabe M, Yamamoto H, Ohtani K, Satomi S, Takayama K, Tominaga T
  • Journal Title: Shock Waves Volume: -
• [Journal Article] Tissue dissection before direct manipulation to the pathology with pulsed laser-induced liquid jet system in skull base surgery - Preservation of fine vessels and maintained optic nerve function (2013)
  • Author(s): Yoshikazu Ogawa, Atsuhiro Nakagawa, Toshikatsu Washio, Tatsuhiko Arafune, Teiji Tominaga
  • Journal Title: Acta Neurochirurgica Volume: 155（10） Issue: 10 Pages: 1879-1876
  • DOI: 10.1007/s00701-013-1817-7
  • Peer Reviewed
• [Journal Article] Pulsed laser-induced liquid jet for skull base tumor removal with vascular preservation through the transsphenoidal approach. 6 th International Congress of the World Federation of Skull Base Societies & 10 th European Skill Base Society Abstract Award 2012 (2013)
  • Author(s): Ogawa Y, Nakagawa A, Tominaga T.
  • Journal Title: 東北医学会雑誌 Volume: 125 Pages: 95-97
• [Journal Article] Pulsed-liquid jet surgical device: Evolution from shock/bubble interaction to clinical application. Proceedings of the Tenth International Conference on Flow Dynamics (2013)
  • Author(s): Nakagawa A, Ohtani K, Ogawa Y, Endo T, Iwasaki M, Niizuma K, Arafune T, Washio T, Kato T, Kudo D, Nakanishi C, Sakurai T, Kamiyama Y, Sato C, Yamada M, Nakano T, Yamashita S, Suzuki T, Tanaka Y, Hagiwara Y, Kunikata H, Kawamoto S, Tominaga T.
  • Journal Title: Proceedings of the 10th International Conference on Flow Dynamics (ICFD2013) Volume: - Pages: 568-569
  • Peer Reviewed
• [Journal Article] Analysis of liquid reservoir effect induced by pulsed laser liquid jet (2013)
  • Author(s): T. Arafune, T. Kato, E. Kobayashi, T. Washio, A. Nakagawa, Y. Ogawa, T. Tominaga
  • Journal Title: Conferemce Proceedings of the 35th Annual International Conference of the IEEE EMBS Volume: - Pages: 918-921
  • Peer Reviewed
• [Journal Article] Experimental Application of Pulsed Laser-Induced Water Jet for Endoscopic Submucosal Dissection: Mechanical Investigation and Preliminary Experiment in Swine. (2012)
  • Author(s): Yamada C
  • Journal Title: Digestive Endoscopy Volume: Epub ahead of print Issue: 3 Pages: 2013-2013
  • DOI: 10.1111/j.1443-1661.2012.01375.x
  • Peer Reviewed
• [Presentation] ピエゾ方式パルスウォータージェットメス：有用性と安全性 (2014)
  • Author(s): 中川敦寛、遠藤俊毅、園田順彦、齋藤竜太、岩崎真樹、藤村幹、 川口奉洋、遠藤英徳、小川欣一、冨永悌
  • Organizer: 第53回日本生体医工学会大会
  • Place of Presentation: 仙台国際センター（宮城県仙台市）
  • Year and Date: 2014-06-24
• [Presentation] Understanding the mechanisms of shock wave injury: implications for blast-induced TBI and development of a novel neurosurgical instrument (2014)
  • Author(s): Nakagawa A, Ohtani K, Goda K, Tominaga T.
  • Organizer: Grand Round
  • Place of Presentation: University of Pittsburgh (Pittsburgh, U.S.A.)
  • Year and Date: 2014-05-21
  • Invited
• [Presentation] Mechanism of traumatic brain injury at distant locations after blast wave exposure: Preliminary results from animal and phantom experiments. (2014)
  • Author(s): Nakagawa A, Ohtani K, Goda K, Tominaga T.
  • Organizer: invited lecture
  • Place of Presentation: Eastern Virginia Medical School (Norfolk, U.S.A)
  • Year and Date: 2014-05-19
  • Invited
• [Presentation] 最大限の病変摘出と機能温存の両立を支援するパルスジェットメス：薬事承認申請、市場創出に向けた取り組み (2014)
  • Author(s): 中川敦寛、小川欣一、遠藤俊毅、園田順彦、岩崎真樹、斎藤竜太、山下慎一、中野徹、中西史、櫻井、國方彦志、中佑治、鈴木、川本俊輔、冨永悌二
  • Organizer: 第23回脳神経外科手術と機器学会
  • Place of Presentation: ヒルトン福岡シーホーク（福岡県福岡市）
  • Year and Date: 2014-04-18 – 2014-04-19
• [Presentation] 最大限の病変摘出と機能温存の両立を支援するパルスジェットメス：低侵襲手術用治療器開発に向けた取り組み (2013)
  • Author(s): 中川敦寛、小川欣一、隈部俊宏、遠藤俊毅、岩崎真樹、新妻邦泰、荒船龍彦、鷲尾利克、加藤峰士、冨永悌二
  • Organizer: 第22回 脳神経外科手術と機器学会
  • Place of Presentation: キッセイホール（長野県松本市）
• [Presentation] Translational research for blast-induced traumatic brain injury: Injury mechanism to development of medical instruments (2013)
  • Author(s): Nakagawa A, Ohtani K, Arafune T, Washio T, Iwasaki M, Endo T, Ogawa Y, Takayama K, Tominaga T.
  • Organizer: 29th Interntational Symposium on Shock Wave
  • Place of Presentation: Memorial Union (Mdison, WI, U. S. A.)
• [Presentation] 衝撃波のトランスレーショナルリサーチ：脳損傷から医療機器開発まで (2013)
  • Author(s): 中川敦寛、大谷清伸、小川欣一、遠藤俊毅、岩崎真樹、鷲尾利克、荒船龍彦、加藤峰士、山内康司、冨永悌二
  • Organizer: 第9回流体科学におけるバイオ・医療に関する講演会
  • Place of Presentation: 東北大学流体科学研究所
• [Presentation] Piezo actuator-driven pulsed water jet for neurosurgery: laboratory evaluation with the swine model and implications of mechanical properties (2013)
  • Author(s): Nakagawa A, Endo T, Ogawa Y, Iwasaki M, Niizuma K, Kanamori M, Washio T, Tominaga T.
  • Organizer: 4th International MASSIN Congress
  • Place of Presentation: 神戸ポートピアホテル（兵庫県神戸市）
• [Presentation] Pulsed-Liquid Jet Surgical Device: Evolution from Shock Bubble Interaction to Clinical Application (2013)
  • Author(s): Nakagawa A. Ohtani K, Ogawa Y, Endo T, Iwasaki M, Niizuma K, Arafune T, Washio T, Kato T, Kudo D, Irinoda T, Nakanishi C, Sakurai T, Kamiyama Y, Sato C, Yamada M, Nakano T, Yamashita S, Suzuki T, Tanaka Y, Takagi N, Imai Y, Hagiwara Y, Kunikata H, Kawamoto S, Tominaga T.
  • Organizer: 10th International Conference on Flow Dynamics
  • Place of Presentation: 仙台国際センター（宮城県仙台市）
• [Presentation] Pulsed laser-induced liquid jet for skull base tumor removal with vascular preservation through the transsphenoidal approach (2012)
  • Author(s): Yoshikazu Ogawa, Atsuhiro Nakagawa, Teiji Tominaga
  • Organizer: 6th international congress of the world federation of skull base societies & 10th european skull base congress
  • Place of Presentation: Brighton, United Kingdom
• [Presentation] Tissue dissection without direct manipulation - pulsed laser- induced liquid jet (2012)
  • Author(s): Yoshikazu Ogawa, Atsuhiro Nakagawa, Teiji Tominaga
  • Organizer: 日本脳神経外科学会第71回学術総会
  • Place of Presentation: 大阪府
• [Presentation] 最大限の病変摘出と機能温存の両立を支援するパルスジェットメス：多施設臨床試験 中間報告． (2012)
  • Author(s): 中川敦寛、小川欣一、石井 雄道、田原 重志、天野 耕作、川俣 貴一、堀口 健太郎、矢野 茂敏、倉津 純一、佐伯 直勝、岡田 芳和、寺本明、 冨永 悌二．
  • Organizer: 日本脳神経外科学会第71回学術総会
  • Place of Presentation: 大阪府
• [Book] レーザー誘発液体ジェットを用いた頭蓋底腫瘍摘出 困難な脳神経外科手術―最近の進歩 (2014)
  • Author(s): 小川欣一、中川敦寛、冨永悌二
  • Publisher: 先端医療 脳神経外科
• [Remarks] 知と創生宮城県エリア
  • URL: http://sendai-cyber.icr-eq.co.jp/project/development/files/development_01_07.pdf
• [Remarks] 東北大学シーズ集
  • URL: http://www.rpip.tohoku.ac.jp/seeds/profile/312/lang:jp/