脱附性医用高频电刀的研究现状及发展趋势

doi:10.3901/JME.2020.01.175

机械工程学报 ›› 2020, Vol. 56 ›› Issue (1): 175-186.doi: 10.3901/JME.2020.01.175

脱附性医用高频电刀的研究现状及发展趋势

陆龙生^1,2, 李凯凯^1,2, 谢颖熙^1,2, 万珍平^1,2, 丁焕文³, 张志辉⁴, 汤勇^1,2

1. 华南理工大学机械与汽车工程学院广州 510640;
2. 广东省功能结构与器件智能制造工程实验室广州 510640;
3. 广州市第一人民医院广州 510180;
4. 吉林大学工程仿生教育部重点实验室长春 130022

收稿日期:2019-03-04 修回日期:2019-07-26 出版日期:2020-01-05 发布日期:2020-03-09
通讯作者: 谢颖熙(通信作者),男,1989年出生,博士,副教授。主要研究方向为先进表面功能结构制造、先进电子器件制造、先进纳米材料制造等。E-mail:xieyingxi@scut.edu.cn
作者简介:陆龙生,男,1981年出生,博士,教授,博士研究生导师。主要研究方向为表面微纳功能结构制造。E-mail:meluls@scut.edu.cn;李凯凯,男,1996年出生,硕士研究生。主要研究方向为表面功能结构制造。E-mail:likaikai.scut@gmail.com;万珍平,男,1971年出生,博士,教授,博士研究生导师。主要研究方向为现代加工理论与技术、表面功能结构制造。E-mail:zhpwan@scut.edu.cn;丁焕文,男,1965出生,博士,教授,主任医师。主要研究方向为数字化骨科修复技术、3D打印医疗器械研究。E-mail:dhuanwen123@aliyun.com;张志辉,男,1976年出生,博士,教授,博士研究生导师。主要研究方向为工程仿生、金属复合材料制备与应用研究。E-mail:zhzh@jlu.edu.cn;汤勇,男,1962年出生,博士,教授,博士研究生导师。主要研究方向为微制造、表面功能结构制造。E-mail:ytang@scut.edu.cn
基金资助:
国家自然科学基金（51775197，U1601203）和广东省自然科学基金（2019A1515011530）资助项目。

Research Status and Development Trend of Desorption Surgical Electromes

LU Longsheng^1,2, LI Kaikai^1,2, XIE Yingxi^1,2, WAN Zhenping^1,2, DING Huanwen³, ZHANG Zhihui⁴, TANG Yong^1,2

1. School of Mechanical and Automotive Engineering, South China University of Technology, Guangzhou 510640;
2. Intelligent Manufacturing Engineering Laboratory of Functional Structure and Devices in Guangdong Province, Guangzhou 510640;
3. Guangzhou First People's Hospital, Guangzhou 510180;
4. The Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun 130022

Received:2019-03-04 Revised:2019-07-26 Online:2020-01-05 Published:2020-03-09

摘要/Abstract

摘要： 医用高频电刀通过刀头尖端电弧放电并产生热量完成组织的切割和止血工作，是外科手术中的重要工具。在手术过程中，高频电刀温度过高会使血液和软组织脱水结痂甚至炭化，粘连并包覆刀头，进而对手术过程和医疗效果产生严重影响。为能够有效解决医用高频电刀表面的生物组织粘连问题，国内外诸多学者开展了电刀表面的脱附性研究，具有明显疏血、散热降温、抗组织粘附等效果的仿生脱附性医用高频电刀已成为该领域的研究热点和重要发展方向。按照现有脱附性医用高频电刀的结构特点进行归纳分类并详细介绍其研究和应用现状，着重介绍和分析仿生高频电刀的动植物脱附模型，总结国内外关于高频电刀表面脱附结构或涂层的制造方法，分析讨论目前脱附性医用高频电刀所存在的问题，最后对其未来的发展趋势进行展望。

关键词: 医用高频电刀, 脱附性能, 仿生模型, 制造方法

Abstract: As an important tool in surgical operation, surgical electromes are used to perform tissue cutting and hemostasis by discharging arc at the tip of the electromes and generating heat. In the process of surgery, over-high temperature of electromes make the blood and soft tissue dehydrate to form a scab even carbonize. Therefore, the electromes' head are adhered and covered, making a serious impact on the surgical process and medical effects. In order to effectively solve these problems, many scholars at home and abroad carry out studies on the surface adhesion of electrotomes. Some bionic desorption surgical electrotomes with obvious effects of anti-blood, thermolysis, anti-tissue-adhesivity and so on become a research hotspot and an important development direction in this field. The existing desorption electrotomes are classified according to the structural characteristics, and its research and application status are introduced in detail. Then the animal and plant desorption models of bionic electromes are emphatically introduced and analyzed, as well as the manufacturing methods of desorption microstructures on electromes' surface are summarized. Furthermore, the problems on exist the current desorption electromes are analyzed and discussed, and it is also proposed that more endeavors should be attempted to what in the future.

Key words: surgical electromes, desorption performance, bionic model, manufacturing method

中图分类号:

TH777

陆龙生, 李凯凯, 谢颖熙, 万珍平, 丁焕文, 张志辉, 汤勇. 脱附性医用高频电刀的研究现状及发展趋势[J]. 机械工程学报, 2020, 56(1): 175-186.

LU Longsheng, LI Kaikai, XIE Yingxi, WAN Zhenping, DING Huanwen, ZHANG Zhihui, TANG Yong. Research Status and Development Trend of Desorption Surgical Electromes[J]. Journal of Mechanical Engineering, 2020, 56(1): 175-186.

参考文献

[1] OCHSNER J. Surgical knife[J]. Texas Heart Institute Journal,2009,36(5):441-443.
[2] 杨勇,田志杰. 现代外科手术刀[J]. 临床外科杂志,2008,16(7):437-438. YANG Yong,TIAN Zhijie. Modern surgical scalpel[J]. Journal of Clinical Surgery,2008,16(7):437-438.
[3] 王锦航,董福生,董玉英. 现代手术刀的研究进展[J]. 医学理论与实践,2015,28(4):447-449. WANG Jinhang,DONG Fusheng,DONG Yuying. Research progress of modern scalpel[J]. The Journal of Medical Theory and Practice,2015,28(4):447-449.
[4] 周伟伟,穆燕. 高频电刀的常见意外伤害原因分析及预防进展[J]. 护理学报,2012,19(12):14-16. ZHOU Weiwei,MU Yan. Cause Analysis and Prevention Progress of Common Accidental Injuries of High Frequency Electrotome[J]. Journal of Nursing(China),2012,19(12):14-16.
[5] JI G W,WU Y Z,WANG X,et al. Experimental and clinical study of influence of high-frequency electric surgical knives on healing of abdominal incision[J]. World Journal of Gastroenterology:WJG,2006,12(25):4082.
[6] DODDE R E,GEE J S,GEIGER J D,et al. Monopolar electrosurgical thermal management for minimizing tissue damage[J]. IEEE Transactions on Bio-Medical Engineering,2012,59(1):167-173.
[7] LOFFER F D,BRADLEY L D,BRILL A I,et al. Hysteroscopic fluid monitoring guidelines:From the ad hoc committee on hysteroscopic fluid guidelines of the American Association of Gynecologic Laparoscopists[J]. The Journal of the American Association of Gynecologic Laparoscopists,2000,7(1):167-168.
[8] 张同喜. 附着力、内聚力与润湿性的简明判据[J]. 青海大学学报,2008,26(1):77-79. ZHANG Tongxi. Concise criteria for adhesion,cohesion and wettability[J]. Journal of Qinghai University,2008,26(1):77-79.
[9] ZHENG L,WAN J,LONG Y,et al. Effect of high-frequency electric field on the tissue sticking of minimally invasive electrosurgical devices[J]. Royal Society Open Science,2018,5(7):180125.
[10] 郑建都.一种不粘电刀及电刀头的冷却方法:中国,201410460681.X[P]. 2014-11-26. ZHENG Jiandu. A non-sticking electrome amd cooling method for its head:China,201410460681.X[P]. 2014-11-26.
[11] YAO G,ZHANG D,GENG D,et al. Improving anti-adhesion performance of electrosurgical electrode assisted with ultrasonic vibration[J]. Ultrasonics,2018,84:126-133.
[12] 李明守,吴长兰.一种内置加热单元的手术刀:中国,201710759377.9[P]. 2018-01-19. LI Mingshou,WU Changlan. A surgical scapel with built-in heating unit:China,201710759377.9[P]. 2018-01-19.
[13] HSU Y L,LEE C H,CHIU S M,et al. Anti-Sticking Properties of PVD CrWNx,CrOx and ZrOx Coatings on Medical Electrode Application[J]. Defect & Diffusion Forum,2010,297-301:656-663.
[14] OU K L,CHU J S,HOSSEINKHANI H,et al. Biomedical nanostructured coating for minimally invasive surgery devices applications:Characterization,cell cytotoxicity evaluation and an animal study in rat[J]. Surgical Endoscopy,2014,28(7):2174-2188.
[15] CHENG H Y,OU K L. The application of advanced nanostructured film in electrosurgical device:Anti-sticking behavior and thermal injury[J]. Journal of Nanomedicine & Nanotechnology,2015,06(3):1-8.
[16] OU K L,WENG C C,SUGIATNO E,et al. Effect of nanostructured thin film on minimally invasive surgery devices applications:Characterization,cell cytotoxicity evaluation and an animal study in rat[J]. Surgical Endoscopy,2016,30(7):3035-3049.
[17] SHEN Y D,LIN L H,CHIANG H J,et al. Research of electrosurgical unit with novel antiadhesion composite thin film for tumor ablation:Microstructural characteristics,thermal conduction properties,and biological behaviors[J]. Journal of Biomedical Materials Research Part B:Applied Biomaterials,2016,104(1):96-105.
[18] ÇEVIKER N,KESKIL S,BAYKANER K. A new coated bipolar coagulator:Technical note[J]. Acta Neurochirurgica,1998,140(6):619-620.
[19] 杨光,段海真,邓崇第,等. 一种不粘高频电手术刀:中国,201720045622.5[P]. 2018-04-17. YANG Guang,DUAN Haizhen,DENG Chongdi,et al. A non-sticky high frequency electrome:China,201720045622.5[P]. 2018-04-17.
[20] CHENG C W,LIN C Y,TSENG W P,et al. Electrosurgical unit with micro/nano structure and the manufacturing method thereof:U.S.,13/337,540[P]. 2013-05-30.
[21] 韩志武,曹会娜,关会英,等.一种仿生防粘高频电刀刀头:中国,201410153396.3[P]. 2014-07-02. HAN Zhiwu,CAO Huina,GUAN Huiying,et al. A bionic anti-sticking high frequency electrome' head:China,201410153396.3[P]. 2014-07-02.
[22] HAN Z,FU J,FENG X,et al. Bionic anti-adhesive electrode coupled with maize leaf microstructures and TiO2 coating[J]. RSC Advances,2017,7(72):45287-45293.
[23] ZHANG P,LIU G,ZHANG D,et al. Liquid-Infused surfaces on electrosurgical instruments with exceptional antiadhesion and low-damage performances[J]. ACS Applied Materials & Interfaces,2018,10(39):33713-33720.
[24] 刘光,张鹏飞,陈华伟,等. 载能电刀仿生防粘表面技术[J]. 机械工程学报,2018,54(17):21-27. LIU Guang,ZHANG Pengfei,CHEN Huawei,et al. Bio-inspired anti-adhesion surfaces of electrosurgical scalpel[J]. Journal of Mechanical Engineering,2018,54(17):21-27.
[25] 万健飞,郝汝飞,龙运江,等. PTFE涂层抗粘附电极切割效率和抗粘附性能的时变性研究[J]. 机械工程学报,2018,54(17):2-7. WAN Jianfei,HAO Rufei,LONG Yunjiang,et al. Research on the variations of the incision efficiency and anti-stickong performance of PTFE-coated electrode with operation time[J]. Journal of Mechanical Engineering,2018,54(17):2-7.
[26] BARTHLOTT W,NEINHUIS C. Purity of the sacred lotus,or escape from contamination in biological surfaces[J]. Planta,1997,202(1):1-8.
[27] KOCH K,BHUSHAN B,BARTHLOTT W. Multifunctional surface structures of plants:An inspiration for biomimetics[J]. Progress in Materials Science,2009,54(2):137-178.
[28] CASSIE A,BAXTER S. Wettability of porous surfaces[J]. Transactions of the Faraday society,1944,40:546-551.
[29] HAN Z,FU J,FANG Y,et al. Anti-adhesive property of maize leaf surface related with temperature and humidity[J]. Journal of Bionic Engineering,2017,14(3):540-548.
[30] PU X,LI G,HUANG H. Preparation,anti-biofouling and drag-reduction properties of a biomimetic shark skin surface[J]. Biology Open,2016,5(4):389-396.
[31] 邵静静,蔺存国,张金伟,等. 鲨鱼皮仿生防污研究[J]. 涂料工业,2008,38(10):39-41. SHAO Jingjing,LIN Cunguo,ZHANG Jinwei,et al. Study on shark skin's bionical and antifouling properties[J]. Paint & Coatings Industry,2008,38(10):39-41.
[32] CHEN H,XIN Z,MA L,et al. Investigation on large-area fabrication of vivid shark skin with superior surface functions[J]. Applied Surface Science,2014,316(1):124-131.
[33] MAY R M,MAGIN C M,MANN E E,et al. An engineered micropattern to reduce bacterial colonization,platelet adhesion and fibrin sheath formation for improved biocompatibility of central venous catheters[J]. Clinical and Translational Medicine,2015,4(1):9.
[34] LI C,YANG L J,YAN C C,et al. Biomimetic anti-adhesive surface micro-structures of electrosurgical knife fabricated by fibre laser[J]. Journal of Laser Micro Nanoengineering,2018,13(3):309-313.
[35] 杨立军,刘楠,闫程程,等. 高频电手术刀表面激光制备仿生鲨鱼皮微结构的研究[J]. 陕西科技大学学报,2018,36(5):141-145,158. YANG Lijun,LIU Nan,YAN Chengcheng,et al. Study on biomimetic sharkskin microstructure prepared by laser on the surface of high-frequency electrome[J]. Journal of Shaanxi University of Science & Technology,2018,36(5):141-145,158.
[36] WONG T S,KANG S H,TANG S K,et al. Bioinspired self-repairing slippery surfaces with pressure-stable omniphobicity[J]. Nature,2011,477(7365):443.
[37] TESLER A B,KIM P,KOLLE S,et al. Extremely durable biofouling-resistant metallic surfaces based on electrodeposited nanoporous tungstite films on steel[J]. Nature Communications,2015,6:8649.
[38] CHEN H,ZHANG P,ZHANG L,et al. Continuous directional water transport on the peristome surface of Nepenthes alata[J]. Nature,2016,532(7597):85.
[39] 陈华伟,张鹏飞,张力文,等. 猪笼草口缘区表面液体单方向连续搬运机制[J]. 中国科学基金,2016(3):217-219. CHEN Huawei,ZHANG Pengfei,ZHANG Liwen,et al. Continuous directional water transport on the peristome surface of Nepenthes alata[J]. Bulletin of National Natural Science Foundation of China,2016(3):217-219.
[40] LIU G,ZHANG P,LIU Y,et al. Self-lubricanting slippery surface with wettability gradients for anti-sticking of electrosurgical scalpel[J]. Micromachines (Basel),2018,9(11):591.
[41] 汤勇,周明,韩志武,等. 表面功能结构制造研究进展[J]. 机械工程学报,2010,46(23):93-105. TANG Yong,ZHOU Ming,HAN Zhiwu,et al. Recent research on manufacturing technologies of founctional surface structure[J]. Journal of Mechanical Engineering,2010,46(23):93-105.
[42] SABLON K. Nanoelectrodes for molecular devices:A controllable fabrication[J]. Nanoscale Research Letters,2008,3(7):268.
[43] CELIA E,DARMANIN T,DE GIVENCHY E T,et al. Recent advances in designing superhydrophobic surfaces[J]. Journal of Colloid and Interface Science,2013,402:1-18.
[44] BELLANGER H,DARMANIN T,TAFFIN de GIVENCHY E,et al. Chemical and physical pathways for the preparation of superoleophobic surfaces and related wetting theories[J]. Chemical Reviews,2014,114(5):2694-2716.
[45] JIANG T,GUO Z,LIU W. Biomimetic superoleophobic surfaces:focusing on their fabrication and applications[J]. Journal of Materials Chemistry A,2015,3(5):1811-1827.
[46] OH J K,LU X,MIN Y,et al. Bacterially antiadhesive,optically transparent surfaces inspired from rice leaves[J]. ACS Applied Materials & Interfaces,2015,7(34):19274-19281.
[47] JUNG M,KIM T,KIM H,et al. Design and fabrication of a large-area superhydrophobic metal surface with anti-icing properties engineered using a top-down approach[J]. Applied Surface Science,2015,351:920-926.
[48] LIN C C,LIN H J,LIN Y H,et al. Micro/nanostructured surface modification using femtosecond laser pulses on minimally invasive electrosurgical devices[J]. Journal of Biomedical Materials Research Part B:Applied Biomaterials,2017,105(4):865-873.
[49] HSIAO W T,LIN L H,CHIANG H J,et al. Biomedical electrosurgery devices containing nanostructure for minimally invasive surgery:Reduction of thermal injury and acceleration of wound healing for liver cancer[J]. Journal of Materials Science:Materials in Medicine,2015,26(2):77.
[50] PARK J Y,TENJIMBAYASHI M,MUTO J,et al. Antiadhesion function between a biological surface and a metallic device interface at high temperature by wettability control[J]. ACS Biomaterials Science & Engineering,2018,4(5):1891-1899.
[51] ZHANG P F,CHEN H W,ZHANG L W,et al. Anti-adhesion effects of liquid-infused textured surfaces on high-temperature stainless steel for soft tissue[J]. Applied Surface Science,2016,385:249-256.

脱附性医用高频电刀的研究现状及发展趋势

Research Status and Development Trend of Desorption Surgical Electromes

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