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The use of ultrasonic vibrations transmitted via small diameter wire waveguides represents a technology that has potential for minimally invasive procedures in surgery. This form of energy delivery results in distal tip mechanical vibrations with amplitudes of vibration of up to 50 μm and at frequencies between 20-50 kHz commonly reported. This energy can then be used by micro-cutting surgical tools and end effectors for a range of applications such as bone cutting, cement removal in joint revision surgery and soft tissue cutting. One particular application which has gained regulatory approval in recent years is in the area of cardiovascular surgery in the removal of calcified atherosclerotic plaques and chronic total occlusions. This paper builds on previous work that was focused on the ultrasonic perforation of soft vascular tissue using ultrasonically activated mechanical waveguides and the applied force required to initiate failure in soft tissue when compared with non-ultrasonic waveguides. An ultrasonic device and experimental rig was developed that can deliver ultrasonic vibrations to the distal tip of 1.0 mm diameter nickel-titanium waveguides. The operation of the ultrasonic device has been characterized at 22.5 kHz with achievable amplitudes of vibration in the range of 16 – 40μm. The experimental rig allows the ultrasonically activated waveguide to be advanced through a tissue sample over a range of feedrates and the waveguide-tissue interaction force can be measured during perforation into the tissue. Preliminary studies into the effects of feedrate on porcine aortic arterial tissue perforation forces are presented as part of this work. A range of amplitudes of vibration at the wire waveguide distal tip were examined. The resulting temperature increase when perforating artery wall when using the energized wire waveguides is also examined. Results show a clear multistage failure of the tissue. The first stage involves a rise in force up to some critical force and tissue displacement whereby the cut is initiated. The results show that with increasing ultrasonic amplitude of vibration the perforation force decreases considerably. The current results show that for the range of feedrates investigated 19-95 mm/min at an amplitude of vibration of 34.3 μm there was no significant effect on the perforation initiation force. The ΔT in the tissue 3.0 mm from the point of entry is also presented for a range of amplitudes of vibration.
Wylie, M., McGuinness, G. & Gavin, G. (2011) Soft Tissue Cutting with Ultrasonic Mechanical Waveguides. International Congress on Ultrasonics 2011, Gdansk, 5-8, September. Book of Abstracts : ISBN 978-83-7531-215-7 Proceedings: TBA