• CN:11-2187/TH
  • ISSN:0577-6686

机械工程学报 ›› 2018, Vol. 54 ›› Issue (17): 2-7.doi: 10.3901/JME.2018.17.002

• 特邀专栏:精准微创手术器械创成与制造基础 • 上一篇    下一篇

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PTFE涂层抗粘附电极切割效率和抗粘附性能的时变性研究

万健飞, 郝汝飞, 龙运江, 郑良, 郑靖, 周仲荣   

  1. 西南交通大学摩擦学研究所 成都 610031
  • 收稿日期:2018-01-09 修回日期:2018-05-08 出版日期:2018-09-05 发布日期:2018-09-05
  • 通讯作者: 郑靖(通信作者),女,1974年出生,博士,研究员,博士研究生导师。主要研究方向为生物摩擦学与表面工程。E-mail:zhengj168@163.com
  • 作者简介:万健飞,男,1991年出生。主要研究方向为机械表界面与表面工程。E-mail:616442270@qq.com
  • 基金资助:
    国家自然科学基金资助项目(51290291)。

Research on the Variations of the Incision Efficiency and Anti-sticking Performance of PTFE-coated Electrode with Operation Time

WAN Jianfei, HAO Rufei, LONG Yunjiang, ZHENG Liang, ZHENG Jing, ZHOU Zhongrong   

  1. Tribology Research Institute, Southwest Jiaotong University, Chengdu 610031
  • Received:2018-01-09 Revised:2018-05-08 Online:2018-09-05 Published:2018-09-05

摘要: 电外科手术过程中高频电刀手术电极表面的组织粘附会导致电极变"钝"、变粗,切割效率和操作精度降低。近年来,低表面能的PTFE涂层电极被临床用作抗粘附手术电极,然而,这种抗粘附电极的切割效率和抗组织粘附耐久性尚不清楚。因此,利用摩擦学手段实时测量电切割离体猪肝脏组织试验过程中PTFE涂层电极-组织界面的切割阻力,结合微观形貌和组织切片分析,研究了PTFE涂层电极切割效率和抗粘附性能的时变性。结果表明,PTFE涂层电极的切割效率与抗粘附能力呈负相关。在切割初期,电极表面的PTFE涂层完整涂覆,抗组织粘附效果明显,组织热损伤轻,但切割阻力大,切割效率低;随着切割时间增加,PTFE涂层变薄、局部被电弧烧蚀击穿,切割阻力显著减小,但电极的抗粘附性能急剧下降,组织热损伤加重;随着切割时间继续增加,PTFE涂层完全破坏,抗粘附效果丧失,切割阻力降低到最低值。增大高频电刀输出功率能提高PTFE涂层抗粘附手术电极的切割效率,但涂层破坏加剧,涂层的有效抗粘附时间缩短,组织损伤也显著加剧。可见,在复杂的电外科手术工况下,PTFE涂层电极的切割效率低,抗组织粘附耐久性差。

关键词: PTFE涂层电极, 高频电刀, 抗粘附性能, 切割效率, 组织粘附

Abstract: Tissue sticking upon the active electrode of electrosurgical unit during electrosurgery increases the electrical resistance of electrode and hinders the energy delivery to targeted tissue, then reducing operation efficiency and accuracy. PTFE-coated electrode has been used as anti-sticking electrode in clinic due to low surface energy recently, but little is known about its incision efficiency and anti-sticking durability. The incision resistance of PTFE-coated electrode-tissue interface is measured in a real time during the electrosection cutting process of ex vivo fresh porcine liver tissue, the morphologies of electrode surface are studied using various microscope examinations, and the tissue damage is examined with histotomy, aiming to reveal the variations of the incision efficiency and anti-sticking performance of PTFE-coated electrode with operation time. Results show that there existed an inverse correlation between the incision efficiency and anti-sticking performance of PTFE-coated electrode. In the initial stage of electrosection cutting, the electrode surface is coated totally with a layer of PTFE and had obvious anti-sticking effect, the thermal damage of liver tissue is slight, but the incision resistance is big, that is, the incision efficiency is low. With the cutting time increasing, the PTFE coating is thinned and punctured locally by arc ablation, the incision resistance reduced significantly, but the anti-sticking effect decreased obviously and the tissue thermal damage is aggravated. As the cutting proceeded further, the PTFE coating is totally destroyed and then its anti-sticking effect did not work. The incision resistance is increased to the minimum. Increasing the output power of electrosurgical unit increased the incision efficiency of PTFE-coated electrode, but the damage of PTFE coating is speeded up so as to shorten its anti-sticking durability remarkably and aggravate the tissue thermal damage. In sum, PTFE coated electrode had a low incision efficiency and inferior anti-sticking durability under the complex electrosurgical condition.

Key words: anti-sticking performance, electrosurgical unit, incision efficiency, PTFE-coated electrode, tissue sticking

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