Journal Article

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

Weng, Chao-Chia, Ruslin, Muhammad, Cheng, Han-Yi, Lin, Yun-Ho, Sugiatno, Erwan, Ou, Keng-Liang

2016

Overview

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.

• Publisher: Springer US,Springer Nature B.V
• Subject: Abdominal Surgery / Animals / Blotting, Western / Burns - pathology / Burns - prevention & control / Carbon - chemistry / Caspase 3 - metabolism / Coated Materials, Biocompatible - chemistry / Copper - chemistry / Cytotoxicity / Dentistry / Disease Models, Animal / Electrodes / Electrosurgery - instrumentation / Gastroenterology / Gynecology / Hepatology / Hydrogenation / Laparoscopy / Liver - surgery / Matrix Metalloproteinase 9 - metabolism / Medicine / Medicine & Public Health / Microscopy / Microscopy, Electron, Scanning / Microscopy, Electron, Transmission / Minimally Invasive Surgical Procedures - instrumentation / Minimally Invasive Surgical Procedures - methods / Nanostructures / NF-kappa B - metabolism / Proctology / Rats / Stainless steel / Stainless Steel - chemistry / Surgery / Temperature / Thermography / Thoracic surgery