Use of ultrasound scalpel in peripheral nerve surgery and its experimental substantiation

A technique of nerve preparation for neurorrhaphia was developed including achievement of even cut and prevention of its end hemorrhage. The technique consists in two-stage intersection of a nerve with refreshment of its ends: preliminary circular cutting of epineurium with the ultrasound scalpel and crossing of nerve fiber bundles with a cutting tool. After such a crossing a kind of supporting "belt" was formed around the perineural cases at the expense of the effect of epineurium welding together with underneath tissues, and this belt prevented coverage retraction, protrusion of intra-epineural contents, shift of little bundles and their prolapse to anastomosis line while suturing. Epineural vessel hemorrhage was absent and that of endoneurium vessels was slight and stopped after a single tamponing. The method of descriptive histology ad morphometry showed that the techique described is sparing with respect to nerve tissue and ensures better topographic specificity of nerve fiber regeneration.