Water Jet Surgery for Sensitive, Selective Dissection

The technique, applicable to many surgical and endoscopic applications, provides good visibility of the operative field and requires a shorter procedure time than conventional surgery.

The anatomically sparing separation of tissue by water jet technology is based on the different physical properties of biologic tissue. The tissue's structure, firmness, and elasticity determine how the tissue will react to a specific level of water pressure, states Erbe Elektromedizin GmbH (Tubingen, Germany), which has developed a new, nonthermal water jet system, called Helix Hydro Jet.

Based on the experiences of users, Erbe cites a number of applications and their advantages. In abdominal surgery, surgeons using the water jet system can see and preserve blood vessels while conserving nerve structures in the pelvic regions. In a partial nephrectomy, water jet surgery can be used to separate renal tissue with minimal bleeding while preserving renal function as much as possible. In radical prostatectomy, selective dissection permits the sparing of neurovascular cords and the selective treatment of the prostatic vasculature, resulting in improved continence and potency, compared to conventional surgery.

Special applicators are available for use in laparoscopic procedures, notes Erbe. In laparoscopic liver surgery, when using the water jet to expose the gallbladder, soft adipose and connective tissue is displaced. Blood vessels, vasculature, and nerves of the hepatic duct system are conserved and can be ligated and divided separately. Good visibility of the operative field is created by continual irrigation and aspiration during the procedure, reducing the risk of trauma to adjacent structures.




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