腹腔鏡術為利用腹腔鏡及其腹腔手術器械於腹腔內的微創開刀手術，在腹腔鏡術中，電燒系統主要功能在於搭配電燒器械，對手術部位進行切割、凝血或止血的功能，施術中易造成沾黏，導致二次撕裂傷，使傷口擴大；由於腹腔鏡具有放大效果，出血點易造成視野清晰度快速下降，而手術器械繁多，主要功能為清潔傷口、提升視野之噴吸水器械與電燒器械為分開的兩部份，施術中易造成操作過於繁雜，使手術時間加長，提高危險性，因此研發複合功能的手術器械有其必要性。
本研究係利用電腦輔助繪圖設計、流體力學、材料力學、表面處理技術、鍍膜檢測技術、統計學以研發設計噴水式抗沾黏電燒器械，系統架構依模組化分為抗沾黏夾鉗模組、噴水管路模組、手握把及傳動模組作為設計考量。使用氮化鉻鎢、氧化鋯及氧化鉻膜之磁控濺射蒸鍍不銹鋼試片，探討表面粗度測定、鍍膜厚度檢測、鍍膜成分檢測、鍍膜結構檢測、水滴接觸角量測之物理性質及探討不銹鋼電燒刀鍍氮化鉻鎢、氧化鋯及氧化鉻膜之抗沾黏功能以提供較適當鍍膜材質作為抗沾黏夾鉗之表面處理。
目前已完成：(1) 噴水式抗沾黏電燒鉗之CAD軟體雛形設計。(2) 三種鍍膜試片之物理性質檢測及分析。(3)三種鍍膜電刀之抗沾黏測試及分析。結果顯示：(1) 設計之電燒鉗能整合噴水功能及抗沾黏功能。(2) 氧化鉻鍍膜試片平均水滴接觸角高達126.6度、含O原子百分比高達36.89%，主要為固溶高氧成分之Cr的面心立方晶體及少量Cr2O3相結構，含高密度OH鍵，吸附C離子能力佳，在三種鍍膜中較具抗沾黏性。(3)經統計分析，三種鍍膜之電刀組織沾黏量皆為有差異。實驗數據顯示，三種鍍膜皆比未表面處理電刀佳，其中以氧化鉻鍍膜之電刀較具抗沾黏效果。
未來研究方向建議：(1) 進一步了解物理氣相沈積製程製備氧化鉻鍍膜，是否對組織有不良之副作用。 (2) 進行雙極電燒實驗，檢測沾黏重量比例。(3) 噴水式抗沾黏電燒鉗結合物理氣相沈積技術之機構製作及測試。

Laparoscopy is one of minimally invasive surgery (MIS) using the laparoscope and the laparoscopic instruments in the abdominal cavity. In laparoscopy, the main functions of the electrosurgical units are that will go along with the electrosurgical instruments and do cutting, coagulation and hemostasis to the operative parts. However, it’s easier to get adhesion in a surgery and it’ll lead to the second laceration and make the trauma bigger. Also, the laparoscope has the effect of magnification. When it bleeds, it will decline the view of the definition. Besides, there are lots of surgery instruments, and the irrigation devices used to clean the trauma and improve the view. Therefore, it might make the surgery complicated, become longer and increase the fatalness. To sum up, it’s really necessary to develop the operative instruments to improve compounded functions.
The main purpose of this study is to design and operate anti-sticking electrosurgical instrument with irrigation for Laparoscope to expert intelligence by the application of the followings, CAD, Fluid Mechanics, Mechanics of Materials, surface preparation technique, physical vapor deposition (PVD) and Statistics. Considering the design, the system architectures categorized by modulation are anti-sticking forcep module, irrigation module, and handle and transmission module. By using three kinds of magnetron sputtering stainless steels which have CrWN, ZrOx and CrOx coating to examine the physical properties of the surface roughness , the thickness, the composition, the structure of thin films, and the contact angle of water droplets; in addition, to investigate the anti-sticking mechanics of electrosurgical instruments which coated with CrWN, ZrOx and CrOx thin films that is more suitable to provide the material of thin films for the anti-sticking forceps of surface preparation instruments.
This research has accomplished the initial concepts includes (1) the overall structure and mechanical components of anti-sticking electrosurgical instrument with irrigation for Laparoscope from the CAD-base design (2) the investigation and

analysis of physical properties for CrWN, ZrOx, CrOx thin films (3) the investigation and analysis of anti-sticking in Monopolar electrosurgical instrument for CrWN, ZrOx, CrOx thin films. The results of this research showed: (1) To combine the functions of irrigation and anti-sticking in electrosurgical instrument for Laparoscope. (2) The CrOx thin films are with the average height of 126.6∘for the contact angle of water droplets and with O are up to 36.89%. Due to CrOx thin films are composed of Cr Face-Centered Cubic Crystal Structure (FCC) with high OH group density and the best absorbency in carbon substance, the CrOx thin films is better than the other two thin films. (3) To determine from Fisher exact Test, the sticking quantity of tissue of CrWN, ZrOx, CrOx thin films are different. The results showed that any one of these three thin films are better than surface treatment PVD electrotome, especially the monpolar electrosurgical instrument with CrOx thin films, is more anti-sticking.
From these results we suggest future research could be (1) understood the procedure of PVD to create CrOx thin film and known if there’s any side effect on tissue, (2) To do the bipolar electrosurgical experiment to analysis the result of the ratio of organization adhesion.(3) To make and test the combination of anti-sticking electrosurgical instrument and PVD.

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