2000 Fiscal Year Final Research Report Summary
Attachments of a Tip-Angling Device and a Working Channel : Development of the Multipurpose Ultrafine Spinal Fiberscope
| Project/Area Number |
10557137
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| Research Category |
Grant-in-Aid for Scientific Research (B).
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| Allocation Type | Single-year Grants |
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| Section | 展開研究 |
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| Research Field |
Anesthesiology/Resuscitation studies
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| Research Institution | NIIGATA UNIVERSITY |
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Principal Investigator |
SHIMOJI Koki SCHOOL OF MEDICINE, NIIGATA UNIVERSITY PROFESSOR, 医学部, 教授 (30040158)
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| Co-Investigator(Kenkyū-buntansha) |
KUROKAWA Satoshi UNIVERSITY MEDICAL HOSPITAL, NIIGATA UNIVERSITY, ASSISTANT, 医学部・附属病院, 助手 (20303117)
TOMITA Misao UNIVERSITY MEDICAL HOSPITAL, NIIGATA UNIVERSITY, LECTURER, 医学部・附属病院, 講師 (60221438)
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| Project Period (FY) |
1998 – 2000
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| Keywords | fiberscope / ultrafine / angling / working channel / drug administration / surgical manipulation / recording physiological events / visual quality |
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| Research Abstract |
The methods for the attachments to the ultrafine fiberscope of a tip-angling device and a working channel of multipurpose uses, such as recording of physiological events, drug administrations and surgical interventions, were studied during this fiscal year.
Fine flexible fiberscopes make it possible to visualize the entire length of the spinal subarachnoid space. However, further access and interventions to the intended structures in the spinal canal have been impossible because of the difficulty of equipping such a fine fiberscope with a tip-angling device and a working channel. Here, we developed fine flexible fiberscopes(1.47 and 1.50 mm in diameter)equipped with a tip-angling device and a working channel. Epidural and subarachnoid spaces were accessed with these fiberscopes in nine pain patients and one patient who underwent subarachnoid cystectomy. The epidural and subarachnoid spaces were easily approached and clearly visualized in all 10 patients without major complications. The fiberscope also reached the epiarachnoid space in all 6 cases tested. The surface of the cord was more clearly observed by angling the tip. Accurate positioning of the tip to a thoracic spinal root was successful in 4 of 5 cases tested. During manipulation of the epidural space, 4 patients noticed root pain ; this pain disappeared following regional injection of 3 ml of 0.5 % lidocaine through a working channel. In two patients, the spinal cord potential from the epidural space was successfully recorded using an electrode inserted through the working channel during step-by-step withdrawal of the fiberscope. Thus, percutaneous interventions to the spinal structures in the epidural and subarachnoid spaces of the pain patients can be achieved using a fine flexible fiberscope with a tip-angling device and a working channel.
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[Publications] Tobita T, Denda S, Takada T, Endoh H, Baba H, Yamakura T, Fukuda S, Shimoji K: "Effects of fentanyl on spinal cord potentials and electromyogram evoked by transcranial magnetic stimulation in man."In Recent advances in Human Neurophysiology, Hashimoto I, Kakigi R(eds), Elsevier Science BV, Amsterdam. 1034-1037 (1998)
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