目前於臨床一般手術或微創手術中，已大量使用電燒刀去進行燒灼及同時止血，但是因為電燒切除組織的過程中會同時產生的周邊不需切除組織的燒傷與及電刀與組織沾黏或者燒灼所產生的氣體等問題。且在近年來少有相關的資料提供完整改善或者量化評估電刀沾黏力等問題的系統，所以本篇研究探討以力學觀點建立一個離體實驗評估電燒刀組織沾黏之情形，再進一步利用現有的技術來改善電刀組織沾黏的情形，同時建立之後電燒器械沾黏情形特性之評估系統。
本篇實驗選用豬肝作為實驗燒灼的組織材料；採用市售不銹鋼及經過拋光後的不銹鋼和表面貼覆聚四氟乙烯(PTFE)與聚乙二醇(PEG)高分子材料共四種電刀，將電燒系統能量參數設定為40瓦特純切割模式，材料試驗機進行10 公厘來回深度燒灼，且在同一塊豬肝進行電燒測試四把不同電刀；一塊豬肝會創造出20個傷口且循環執行6次，因此每一支電刀燒灼30個傷口，並採集相關數據記錄。在於每次0.5、1、2及4秒不同燒灼時間進行實驗相互比較沾黏力量及傷害體積與沾黏重量；運用材料試驗機於每次電燒時記錄電燒刀與組織之間的黏著力，且在每五次燒灼完畢後的電刀利用電子天秤量測記錄電刀與組織沾黏重量，並使用數位照相機記錄豬肝每次燒傷情形再經由ImageJ將傷口尺寸數值化。
聚乙二醇薄膜材料具有較小接觸角，再來為拋光電刀及不銹鋼電刀和聚四氟乙烯電刀；其組織沾黏力結果顯示，在不同的電燒時間點，30次電燒的平均最大沾黏力發生於每次電燒1秒，其中以表面貼附聚乙二醇電刀有最小平均沾黏力，再來為拋光電刀、聚四氟乙烯電刀及不銹鋼電刀；但在電燒時間為每次2和4秒時，其燒灼切割過程中產生較每次0.5秒及1秒還小的沾黏力；電刀造成的傷口與組織沾黏的重量都隨著電燒時間的增加而增加，但其四把不同表面型態及材料之電刀在統計計算上並無明顯差異。
在微創手術中，減少電刀與組織的沾黏是每個研究必須所要克服的重大議題；找到具有較抗沾黏之電刀材料或相關參數減少沾黏或精準控制傷口大小之數據，在本實驗當中電燒兩秒鐘，所造成的沾黏力較小，且切割深度也達到手術目標，所以在本篇研究當中建議採用此參數作為手術的依據。

Recently, electrical surgical unit (ESU) becomes more popular in regular surgery and minimally invasive surgery (MIS) to diathermy. Yet, during tissue removal, the formation of tissue adhesion on the tips and smoke remains a major problem during MIS.
Only limited studies have investigated the influences of energy and material properties of electrode on adhesion surface and further quantify the adhesion phenomenon. This study tries to build an ex vivo tissue adhesion evaluation system of ESU based on the adhesion volume, adhesion strength and weight and histology, This system can become standard evaluation system for ESU and for improvement of current ESU
In this study, four types of monopolar electrical surgical unit materials including commercial stainless steel (SS) (Control), polished SS (experimental 1), polytetrafluoroethylene (PTFE) coated SS (experimental 2) and polyethylene glycol (PEG) coated polished SS (experimental 3) were investigated. Pork liver was used as tissue for cauterization. The blade was linked to the Valley labTM ESU and the operating mode was set at “pure cutting” with power at 40 watts. Four different diathermy times (the contact duration of blade and tissue) of 0.5s, 1s, 2s and 4s were investigated. At beginning, each blade was connected to InstronTM materials testing system (MTS) and given an entire cyclic stroke 10 mm beneath the liver surface. After diathermy, the detach force was recorded for each test, and after every five tests, then the tip of each blade was put on a balance to measure the adhesion weights. The damage volume caused from diathermy for each test was recorded by a digital camera and was quantitated by the software ImageJ. Single liver was tested by 4 blades 5 times and each blade was tested on 6 livers for each cauterizing time.
Surface morphology and roughness analysis by optical microscopy for polish SS tip was used to compare with the commercial SS tip. Contact angle analysis for the hydrophilicity was conducted for all 4 types of tips.
The tip modified with PEG shows significant less contact angle comparing to all other 3 types of tips. The corresponding maximum volume of damage was about 143.34 mm3 (PTFE) and adhesion weights were assessed at around 20.27 mg (PEG). No significant difference in adhesion weight and damaged volume. The maximum adhesion force was occurred at 1 second cauterization, and PEG tip has the smallest adhesion force followed by polished, PTFE and regular SS tip. It is interesting to find the adhesion strengths for 2 and 4 seconds cauterization were less than those for 0.5 and 1 seconds.
This novel ex vivo model allows standardized, objective and quantitative assessment of tissue-ESU-induced adhesion effects and damage in porcine liver tissue. It will likely provide future insight into the understanding mechanism of cauterization between ESU and tissue, and then help in the development of non-stick medical instruments.

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