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

2014 Fiscal Year Final Research Report

• 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
• 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

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.

Free Research Field

脳神経外科学　間脳下垂体　内分泌