Water Jet Dissector

The water-jet dissector, or jet-cutter, is a device that like the ultrasonic dissector is able to produce a selec tive cutting action while discriminating between parenchyma and vascular and biliary structures [24, 25]. This instrument makes use of a high-pressure pump that imparts potential energy to a sterile saline fluid. Via a high-pressure line, the saline is conducted to a nozzle, from which it is delivered as a fine, high-pressure jet stream. By adjusting the pressure and nozzle parameters appropriately, it is possible to use such an instrument for selective cutting of the parenchyma. More resistant structures like veins, arteries, and bile ducts are left intact. Another important factor for the dissection of the parenchyma with the jet-cutter is the depth of penetration of the jet stream. This parameter is determined by pressure and nozzle size. In the pressure range of 60-80 bar, cutting is effective and practicable. There are at least three different systems of jet-cutter commercially available that differ in the accessories (handling or foot-pressure adjusting device) or in the type of pump (liquid-plus-gas or piston pump).

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