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127. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

20.04. - 23.04.2010, Berlin

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Waterjet dissection of peripheral nerves: An experimental study on the sciatic nerve of rats

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  • Christoph Albrecht Tschan - Universitätsmedizin Mainz, Neurochirurgische Klinik und Poliklinik, Mainz, Deutschland
  • Doerthe Keiner - Universitätsmedizin Mainz, Neurochirurgische Klinik und Poliklinik, Mainz, Deutschland
  • Harald Müller - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Institut für Neuropathologie, Mainz, Deutschland
  • Kerstin Schwabe - Medizinische Hochschule Hannover, Neurochirurgische Klinik und Poliklinik, Hannover, Deutschland
  • Michael Robert Gaab - Nordstadtkrankenhaus Klinikum Region Hannover, Neurochirurgische Klinik und Poliklinik, Hannover, Deutschland
  • Clemens Sommer - Universitätsmedizin Mainz, Institut für Neuropathologie, Mainz, Deutschland
  • Joachim K. Krauss - Medizinische Hochschule Hannover, Neurochirurgische Klinik und Poliklinik, Hannover, Deutschland
  • Joachim Oertel - Universitätsmedizin Mainz, Neurochirurgische Klinik und Poliklinik, Mainz, Deutschland

Deutsche Gesellschaft für Chirurgie. 127. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 20.-23.04.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10dgch107

doi: 10.3205/10dgch107, urn:nbn:de:0183-10dgch1077

Published: May 17, 2010

© 2010 Tschan et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: While waterjet dissection in intracranial pathologies has been well evaluated, little is known of its qualities in peripheral nerve surgery. Theoretically, the precise separation qualities could support the preparation of nerves from adjacent tissues and improve the preservation of nerve integrity in peripheral nerve surgery.

Materials and methods: Waterjet dissection with pressures of 20-80 bar was applied on sciatic nerves of 101 rats. The effect of waterjet dissection on the sciatic nerve was evaluated by clinical tests, neurophysiologic examinations and histopathological studies up to 12 weeks after surgery.

Results: With waterjet pressures up to 40 bar, the sciatic nerve was preserved in its integrity in all cases. Functional damaging was observed at pressures of 50 bar and higher. However, all but one rat of the 80 bar subgroup showed complete functional regeneration at 12 weeks after surgery. Histopathologically, small water bubbles were observed around the nerves. At 50 bar and higher, the sciatic nerves showed signs of direct nerve injury. However, all these animals showed histological nerve regeneration after 12 weeks.

Conclusion: Sciatic nerves were preserved functionally and morphologically at pressures up to 40 bar. Between 40 and 80 bar, reliable functional and morphological nerve regeneration occurred. On one hand, this study points out that waterjet pressures up to 40 bar might be applied safely under clinical conditions. On the other hand, the reliable functional and histomorphological regeneration at pressures between 40 and 80 bar might make this a well suited model for peripheral nerve regeneration in further studies.