AIM: To explore the feasibility of a water-jet hybrid knife to facilitate wedge hepatic resection using a natural orifice transluminal endoscopic surgery (NOTES) approach in a non-survival porcine model. METHODS: The ...AIM: To explore the feasibility of a water-jet hybrid knife to facilitate wedge hepatic resection using a natural orifice transluminal endoscopic surgery (NOTES) approach in a non-survival porcine model. METHODS: The Erbe Jet2 water-jet system allows a needleless, tissue-selective hydro-dissection with a pre-selected pressure. Using this system, wedge hepatic resection was performed through three natural routes (trans-anal, trans-vaginal and trans-umbilical) in three female pigs weighing 35 kg under general anesthesia. Entry into the peritoneal cavity was via a 15-mm incision using a hook knife. The targeted liver segment was marked by an APC probe, followed by wedge hepatic resection performed using a water-jet hybrid knife with the aid of a 4-mm transparent distance soft cap mounted onto the tip of the endoscope for holding up the desired plane. The exposed vascular and ductal structures were clipped with Endoclips. Hemostasis was applied to the bleeding cut edges of the liver parenchyma by electrocautery. After the procedure, the incision site was left open, and the animal was euthanized followed by necropsy. RESULTS: Using the Erbe Jet2 water-jet system, trans-anal and trans-vaginal wedge hepatic resection was successfully performed in two pigs without laparoscopic assistance. Trans-umbilical attempt failed due to an unstable operating platform. The incision for peritoneal entry took 1 min, and about 2 h was spent on excision of the liver tissue. The intra-operative blood loss ranged from 100 to 250 mL. Microscopically, the hydro-dissections were relatively precise and gentle, preserving most vessels. CONCLUSION: The Erbe Jet2 water-jet system can safely accomplish non-anatomic wedge hepatic resection in NOTES, which deserves further studies to shorten the dissection time.展开更多
Hot tearing is one of the most serious defects during the casting solidification process.In this study,a new type of multichannel"cross"hot tearing device was designed.The hot cracks initiation and propagati...Hot tearing is one of the most serious defects during the casting solidification process.In this study,a new type of multichannel"cross"hot tearing device was designed.The hot cracks initiation and propagation were predicted by the relationship between temperature,shrinkage force and solidification time during the casting solidification process.The reliability and practicability of the multichannel"cross"hot tearing device were verified by casting experiments and numerical simulations.The theoretical calculation based on Clyne-Davies model and numerical simulation results show that the hot tearing tendency decreases in the order:2024 Al alloy>Al-Cu alloy>Al-Si alloy at a pouring temperature of 670°C and a mold temperature of 25°C.Feeding of liquid films at the end of solidification plays an important role in the propagation process of hot tearing.The decrease of hot tearing tendency is attributed to the feeding of liquid film and intergranular bridging.展开更多
文摘AIM: To explore the feasibility of a water-jet hybrid knife to facilitate wedge hepatic resection using a natural orifice transluminal endoscopic surgery (NOTES) approach in a non-survival porcine model. METHODS: The Erbe Jet2 water-jet system allows a needleless, tissue-selective hydro-dissection with a pre-selected pressure. Using this system, wedge hepatic resection was performed through three natural routes (trans-anal, trans-vaginal and trans-umbilical) in three female pigs weighing 35 kg under general anesthesia. Entry into the peritoneal cavity was via a 15-mm incision using a hook knife. The targeted liver segment was marked by an APC probe, followed by wedge hepatic resection performed using a water-jet hybrid knife with the aid of a 4-mm transparent distance soft cap mounted onto the tip of the endoscope for holding up the desired plane. The exposed vascular and ductal structures were clipped with Endoclips. Hemostasis was applied to the bleeding cut edges of the liver parenchyma by electrocautery. After the procedure, the incision site was left open, and the animal was euthanized followed by necropsy. RESULTS: Using the Erbe Jet2 water-jet system, trans-anal and trans-vaginal wedge hepatic resection was successfully performed in two pigs without laparoscopic assistance. Trans-umbilical attempt failed due to an unstable operating platform. The incision for peritoneal entry took 1 min, and about 2 h was spent on excision of the liver tissue. The intra-operative blood loss ranged from 100 to 250 mL. Microscopically, the hydro-dissections were relatively precise and gentle, preserving most vessels. CONCLUSION: The Erbe Jet2 water-jet system can safely accomplish non-anatomic wedge hepatic resection in NOTES, which deserves further studies to shorten the dissection time.
基金This work was financially supported by the National Natural Science Foundation of China(Grant No.51875365).
文摘Hot tearing is one of the most serious defects during the casting solidification process.In this study,a new type of multichannel"cross"hot tearing device was designed.The hot cracks initiation and propagation were predicted by the relationship between temperature,shrinkage force and solidification time during the casting solidification process.The reliability and practicability of the multichannel"cross"hot tearing device were verified by casting experiments and numerical simulations.The theoretical calculation based on Clyne-Davies model and numerical simulation results show that the hot tearing tendency decreases in the order:2024 Al alloy>Al-Cu alloy>Al-Si alloy at a pouring temperature of 670°C and a mold temperature of 25°C.Feeding of liquid films at the end of solidification plays an important role in the propagation process of hot tearing.The decrease of hot tearing tendency is attributed to the feeding of liquid film and intergranular bridging.
