부산대학교 도서관

Introduction: Traditional liposuction cannulas and ultrasonic liposuction cannulas have had the feature of relative rigidity in common. Herein we introduce a new design that allows a patient's entrance wound to act as a fulcrum, enabling the surgeon's guiding hand to redirect cannulas with long, flexible shafts and highly reinforced swan necks. The nonultrasonic version of this cannula system includes a highly beveled tip adjacent to a triport (Accellerator III) set of openings. The new cannulas easily penetrate fibrous fat, reach fat deposits distant from the entrance wounds, and curve within the subcutaneous tissue below the dermal envelope, thereby reducing the need to move a patient's body position intraoperatively. A novel Teflon entrance wound insert that resembles the shape of a calla lily aids in the use of the system, thereby reducing cannula friction inside the insert and maximizing friction via projections on the outside of the insert. This friction outside of the insert maintains the insert's position in the wound during cannula backstroke.Materials and Methods: Reinforced swan-neck, flexible shaft, triport bevel cannulas (RSFSTBCs) have been used successfully in hundreds of liposuctions performed by one of us (P.J.W.). P.J.W. has also used the Capistrano cannula tip with success. Capistrano cannulas and RSFSTBCs of 2.5 mm and 3.5 mm diameter were compared in 12 patients (eight female and four male) on contralateral but otherwise identical fat deposits.Results: No adverse effects were noted with either system; no indentations, inordinate bruising, seromas, or infections occurred. The reinforced swan-neck cannulas penetrated tissue with greater ease, and the flexible shafts allowed the operator to arc the cannulas to greater distances within the body. Thus the operator could reach more areas with fewer entrance wounds and less movement of patients on the operating table. Novel cannula motions occurred as a result of using the patient's entrance wound as a fulcrum and redirecting the distal shaft and tip of the cannula with an opposing hand.Discussion: The long, flexible shafts of the RSFSTBC system allow for a reduction in the need for cannula entrance wounds. The beveled tip provides for ease of penetration, even in fibrous tissues. The reinforced swan neck, in combination with the flexible shaft, enables the use of both mildly and highly arced cannula paths via several mechanisms.