下鼻甲介粘膜処理用超音波ブレードの開発

抄録

Two ultrasonic surgical systems, SonoSurg^® (Olympus) and Harmonic Scalpel^® (Johnson and Johnson), are frequently used for general chest and abdominal endoscopic surgery. However, their large tips have limited their use in otolaryngology, with only the Harmonic Scalpel^® having been used in a few cases.
SonoSurg^® features 75-micron amplitude, 47-kHz vibration, which results in a high cutting ability with low tissue damage and bleeding, no vellication as caused by an electric knife, no high temperature as brought by the Shou heat knife, and no need of protective glasses for some laser knives.
Since January, 2002, we have been collaborating with the Olympus Corporation of Japan in the development of a new fine spatula blade (3.8mm in diameter, 100mm long) to be used with SonoSurg^® in nasal surgery. We have used SonoSurg^® with the new blade for the treatment of inferior nasal turbinate with the nasal conchotomy in seven patients with allergic rhinitis and five with chronic hypertrophic rhinitis. The new system was found to be very effective, a short surgical time (procedure completed within 5 minutes), and with good working space even in pediatric surgery. The clinical outcomes were satisfactory, with a final improvement rate of 75%. This latest fine-grip prototype SonoSurg^® provides better management in otolaryngology-Head and Neck Surgery than does the Harmonic Scalpel^®.