A NEWLY DEVELOPED ENDOSCOPIC ULTRASONIC ASPIRATION SYSTEM AND ITS CLINICAL-APPLICATION

Ultrasonic aspirators are frequently employed because they do not need sophisticated techniques and allow dissection of soft tissues from ma jor blood vessels and nerves without damaging them. However, in endosc opic surgery, they have been used only for lithotripsy (amplitude 50-1 00 mum). The authors have developed a new endoscopic ultrasonic aspira tion (EUA) system with probes that are strong enough for high amplitud e waves (200-300 mum) and long enough for endoscopic surgery. Furtherm ore, the equipment includes a coagulating system. After confirmation o f the safety and efficacy of this system in canine experiments, 10 cas es of bladder tumour and six cases of prostate hypertrophy were treate d by transurethral aspiration. This system was also employed in four c ases of laparoscopic pelvic lymphadenectomy. Bladder tumours were aspi rated very rapidly and the coagulating system worked efficiently. Howe ver, during aspiration of prostate hypertrophy the visual field was no t extremely clear and the operation time was prolonged. With this syst em laparoscopic pelvic lymphadenectomy could be done easily and safely . In the near future, refined versions of the EUA system should be eff ective for endoscopic surgery not only in transurethral surgery but al so via laparoscopy.