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Effect of nanostructured thin film on minimally invasive surgery devices applications: characterization, cell cytotoxicity evaluation and an animal study in rat

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Abstract

Background

Minimally invasive surgery is performed using an endoscope and other instruments including the electrosurgical units. However, concerns including surgical smoke, tissue sticking and thermal injury are remaining in electrosurgery.

Aims

Accordingly, a newly developed electrosurgical electrode coating with hydrogenated Cu-incorporated diamond-like carbon (DLC-Cu) film is purposed to improve the instrument performance.

Methods

The morphologies of DLC-Cu surfaces were characterized using transmission electron microscopy, scanning electron microscopy and atomic force microscopy. In this study, lesions were made on the liver lobes of adult rats, using a monopolar electrosurgical unit equipped with untreated stainless steel electrodes or treated-electrodes. Animals were killed for evaluations at 0, 3, 7 and 28 days postoperatively.

Results

Treated-electrodes generate less sticking tissues and adhesive blood cells. Thermography revealed that the surgical temperature in liver tissue from the treated-electrode was significantly lower than the untreated-electrode. Total injury area of livers treated with treated-electrodes was significantly smaller than the untreated-electrodes treatment. Moreover, treated-electrodes caused a relatively smaller area of lateral thermal injury, a smaller area of fibrotic tissue and a faster process of remodeling than the untreated-electrodes. Western blot analysis showed that rats treated with treated-electrode expressed lower levels of NF-κB, caspase-3 and MMP-9 than untreated-electrode. Immunofluorescence staining for caspase-3 revealed that the untreated-electrode caused more serious injury.

Conclusions

This study reveals that the plating of electrodes with hydrogenated Cu-incorporated diamond-like carbon film is an efficient method for improving the performance of electrosurgical units, and should benefit wound remodeling. However, more tests must be carried out to confirm these promising findings in human patients.

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Acknowledgments

The authors would like to thank the Ministry of Health and Welfare, Taiwan, for financially supporting this research under contract number MOST 103-3114-Y-043-012.

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Author notes

    Authors and Affiliations

    1. School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 110, Taiwan

      Keng-Liang Ou & Chao-Chia Weng

    2. Research Center for Biomedical Devices and Prototyping Production, Taipei Medical University, Taipei, 110, Taiwan

      Keng-Liang Ou, Chao-Chia Weng, Erwan Sugiatno, Muhammad Ruslin & Han-Yi Cheng

    3. Research Center for Biomedical Implants and Microsurgery Devices, Taipei Medical University, Taipei, 110, Taiwan

      Keng-Liang Ou & Han-Yi Cheng

    4. Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, New Taipei City, 235, Taiwan

      Keng-Liang Ou

    5. Department of Prosthodontic, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia

      Erwan Sugiatno

    6. Department of Oral and Maxillofacial Surgery, Facuty of Dentistry, University of Hasanuddin, Makassar, Indonesia

      Muhammad Ruslin

    7. Department of Pathology, Taipei Medical University, Taipei, 110, Taiwan

      Yun-Ho Lin

    8. Graduate Institute of Biomedical Materials and Tissue Engineering, Taipei Medical University, Taipei, 110, Taiwan

      Han-Yi Cheng

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    Correspondence to Yun-Ho Lin or Han-Yi Cheng.

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    Keng-Liang Ou, Chao-Chia Weng, Erwan Sugiatno, Muhammad Ruslin, Yun-Ho Lin and Han-Yi Cheng have no conflict of interests.

    Additional information

    Keng-Liang Ou and Chao-Chia Weng have contributed equally to this work.

    All financially supporting have been listed in the Acknowledgment section in the manuscript.

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    Ou, KL., Weng, CC., 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. Surg Endosc 30, 3035–3049 (2016). https://doi.org/10.1007/s00464-015-4596-9

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    • DOI: https://doi.org/10.1007/s00464-015-4596-9

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