Abstract
The integration of cutting and anesthesia within a single surgical instrument presents a significant opportunity to increase precision and reduce mechanical injury. This study introduces an innovative integrated water jet system that synergistically combines tissue dissection with localized drug delivery. A dedicated experimental platform was developed on the basis of hydrodynamic principles, enabling synchronous cutting and anesthesia. Systematic evaluations were conducted through cutting-diffusion experiments, tissue surface morphology analysis, and spatial diffusion tracking of anesthetics via photoacoustic imaging. The results demonstrated a nonlinear positive correlation between jet parameters (pressure and nozzle diameter) and both the cutting depth and diffusion distance. The optimal performance was achieved at distinct parameters for different tissue types: 4 MPa with a 0.2 mm nozzle for muscle tissue, and 8 MPa with a 0.2 mm nozzle for adipose tissue. Compared with conventional scalpel excision, the water jet technique significantly reduced tissue damage, as evidenced by a 51% reduction in fiber breakage and a 35% decrease in damaged area, while preserving up to 39.45 μm of functional structure. Furthermore, photoacoustic imaging revealed nonmonotonic diffusion dynamics of the anesthetic, with the maximum diffusion distance occurring adjacent to the cutting depth (18.31 ± 2 mm), confirming a “cutting-guided diffusion” mechanism. These findings establish a foundational framework for device-drug synergy in surgery, advancing the development of multifunctional, minimally invasive technologies.
Data availability
The data that support the findings of this study are available from thecorresponding author upon reasonable request.
References
Hajilo, P., Imani, B., Zandi, S. & Mehrafshan, A. Comparing the intraoperative and postoperative complications of the scalpel and electrocautery techniques for severing the inner layers of the lumbar disc during discectomy surgery. Front. Surg. 10, 1264519 (2023).
Elmore, L. et al. Evaluating the healing potential of J-plasma scalpel-created surgical incisions in Porcine and rat models. Biomedicines 12, 277 (2024).
Barati, B. et al. Scalpel versus electrocautery skin incisions in postauricular tympanoplasty: a randomized clinical trial study. Egypt. J. Otolaryngol. 41, 105 (2025).
Hreha, P. et al. Water jet technology used in medicine. Tehnicki Vjesn. 17, 237–240 (2010).
Papachristou, D. N. & Barters, R. Resection of the liver with a water jet. Br. J. Surg. 69, 93–94 (1982).
Hata, Y. et al. Liver resection in children, using a water-jet. J. Pediatr. Surg. 29, 648–650 (1994).
Une, Y. et al. Liver resection using a water jet. Cancer Chemother. Pharmacol. 23, 74–S77 (1989).
Izumi, R. et al. Hepatic resection using a water jet dissector. Surg. Today. 23, 31–35 (1993).
Rau, H., Duessel, A. & Wurzbacher, S. The use of water-jet dissection in open and laparoscopic liver resection. HPB 10, 275–280 (2008).
Gilling, P. J. et al. Five-year outcomes for aquablation therapy compared to TURP: results from a double-blind, randomized trial in men with LUTS due to BPH. Can. J. Urol. 29, 10960–10968 (2022).
Elterman, D. et al. Meta-analysis with individual data of functional outcomes following aquablation for lower urinary tract symptoms due to BPH in various prostate anatomies. BMJ Surg. Interventions Health Technol. 3, e000090 (2021).
Nguyen, D. D. et al. Waterjet ablation therapy for endoscopic resection of prostate tissue trial (WATER) vs WATER II: comparing aquablation therapy for benign prostatic hyperplasia in 30–80 and 80–150 mL prostates. BJU Int. 125, 112–122 (2020).
Cecinato, P. et al. Endoscopic submucosal dissection in colorectal neoplasia performed with a waterjet system-assisted knife: higher en-bloc resection rate than conventional technique. Clin. Endoscopy. 55, 775–783 (2022).
Kotecha, K. et al. Waterjet pulse lavage as a safe adjunct to video assisted retroperitoneal debridement in necrotising pancreatitis. Surg. Endosc. 38, 6973–6979 (2024).
Wormald, J. C., Wade, R. G., Dunne, J. A., Collins, D. P. & Jain, A. Hydrosurgical debridement versus conventional surgical debridement for acute partial-thickness burns. Cochrane Database Syst. Rev. (2020).
Shimada, K., Ojima, Y., Ida, Y. & Matsumura, H. Efficacy of Versajet hydrosurgery system in chronic wounds: a systematic review. Int. Wound J. 18, 269–278 (2021).
Xia, L. et al. A retrospective cohort study comparing the clinical outcomes of the hydrosurgery system and traditional Single-Incision surgery for axillary osmidrosis. J. Cosmet. Dermatol. 24, e16755 (2025).
Moon, B. & Kim, Y. J. Comparison of effectiveness and associated complications between conventional subdermal excision and hydrosurgery (VersajetTM) for osmidrosis. Aesthetic Plast. Surg. 45, 3029–3036 (2021).
Azab, M. A., Sarhan, K., Atallah, O., Kammoun, B. & Hazim, A. Slicing through complexity: a systematic review assessing the efficacy and safety of water-jet dissection in neurosurgical procedures with technical suggestions. Neurosurg. Rev. 48, 432 (2025).
Zhao, J., Song, X. F., Wei, X., Yu, W. & Jing, X. Non-rigid cutting characteristics and separation mechanisms of soft muscle tissue under waterjet impact. Proc. Institution Mech. Eng. Part. H: J. Eng. Med. 239, 485–497 (2025).
Babaiasl, M. et al. Predictive mechanics-based model for depth of cut (DOC) of waterjet in soft tissue for waterjet-assisted medical applications. Med. Biol. Eng. Comput. 58, 1845–1872 (2020).
Srivastava, A., Kundu, A. & Paul, A. R. A detailed review of the recent development of needle-free drug delivery devices. J. Med. Eng. Technol. 2025, 1–20 (2025).
Zhu, Y., Kang, C., Cai, W. & Huang, C. Drug injection and dispersion characteristics of an air-powered needle-free injector. Med. Eng. Phys. 109, 103906 (2022).
Jing, Y., Magnin, I. E. & Frindel, C. Monte Carlo simulation of water diffusion through cardiac tissue models. Med. Eng. Phys. 120, 104013 (2023).
Caine, M. et al. In situ evaluation of Spatiotemporal distribution of doxorubicin from Drug-eluting beads in a tissue mimicking Phantom. Eur. J. Pharm. Sci. 160, 105772 (2021).
Mathias, E. V., Aponte, J., Kornfield, J. A. & Ba, Y. Properties of small molecular drug loading and diffusion in a fluorinated PEG hydrogel studied by 1 H molecular diffusion NMR and 19 F spin diffusion NMR. Colloid Polym. Sci. 288, 1655–1663 (2010).
Bálint, Š. et al. Diffusion and cellular uptake of drugs in live cells studied with surface-enhanced Raman scattering probes. J. Biomed. Opt. 15, 027005–027005 (2010).
Abrahams, M. S., Panzer, O., Atchabahian, A., Horn, J. L. & Brown, A. R. Case report: limitation of local anesthetic spread during ultrasound-guided interscalene block. Description of an anatomic variant with clinical correlation. Reg. Anesth. Pain Med. 33, 357–359 (2008).
Tsutsumi, A., Umehara, K., Ono, H. & Kawakami, N. Types of psychosocial job demands and adverse events due to dental mismanagement: a cross sectional study. BMC Oral Health. 7, 1–6 (2007).
Šimek, J., Šmejkal, K., Jakl, M. & Trlica, J. Systemic toxic effects of Mesocain® in routine surgical practice upon iatrogenic overdose requiring cardiopulmonary resuscitation-case report. Rozhledy V Chirurgii: Mesicnik Ceskoslovenske Chirurgicke Spolecnosti. 102, 257–260 (2024).
Wong, S. et al. Image analysis comparison of nerve staining with food dye, methylene blue or tissue marker. Veterinary Anaesth. Analg. 51, 35–43 (2024).
Zhao, J. et al. Tissue-Selective separation mechanism of Multi-type soft tissues under waterjet impact for Low-Trauma cutting surgery. J. Ann. Biomed. Eng. 53, 2612–2625 (2025).
Derakhshan, R., Ahmadian, M., Chizari, M. & Samimiardestani, H. Trimming of sheep spinal cord by waterjet; an experimental study. Heliyon 9, 2563 (2023).
Cui, D. et al. Experimental study on the effect of water jet cutting parameters on maize stalks. Agriculture 13, 880 (2023).
Popan, I. A., Contiu, G. & Campbell, I. In MATEC Web of Conferences. 01009 (EDP Sciences, 2025).
Peneva, M., Gjorgjeska, A., Ginoski, V., Breshkovska, H. & Tolevska, R. D. Electrosurgical microneedle versus scalpel skin incisions in the facial region. Sanamed 13, 269–273 (2018).
Ravi, R. R. & Srinivasu, D. Jet pressure influence on micro-abrasive waterjet trepanned hole in CFRP composite material. Manuf. Technol. Today. 22, 24–29 (2023).
Zeng, D., Tang, Z., Wang, W., Wang, Z. & Li, J. Experimental investigation of the optimal driving pressure for a larger-volume controllable jet injection system. Med. Eng. Phys. 119, 104033 (2023).
Zhongwei, H., Wangyuan, L. & Xipeng, X. Experimental study on the cutting characteristics of three typical biological soft tissues. J. Mech. Eng. 52, 186–192 (2016).
Liu, Z. et al. Recent advances in soft biological tissue manipulating technologies. Chin. J. Mech. Eng. 35, 89 (2022).
Wong, S. L. et al. Sentinel lymph node biopsy and management of regional lymph nodes in melanoma: American society of clinical oncology and society of surgical oncology clinical practice guideline update. J. Clin. Oncol. 36, 399–413 (2018).
Muldrew, K. et al. Cryobiology of articular cartilage: ice morphology and recovery of chondrocytes. Cryobiology 40, 102–109 (2000).
Prescher, H. et al. Scalpel edge roughness affects post-transection peripheral nerve regeneration. Surg. Open 4, 1–6 (2021).
Casutt, M. M., Scheeder, M. R., Escher, F., Dufey, P. A. & Kreuzer, M. Relating texture properties and composition of bovine fat tissue. Lipid/Fett 101, 283–290 (1999).
Sidorov, D. et al. Surgical and pathomorphological results of total mesorectumectomy by using waterjet dissection technique in patients with rectal cancer. Surg. Oncol. 6, 17–22 (2016).
Funding
This study was financially supported by the National Natural Science Foundation of China (No. 52474208), the Chongqing Talents·ProgramExcellent·ScientistProject (No.cstc2024ycjh-bgzxm0016) and Excellent Youth Team Project for the Central Universities (No.2023CDJYXTD-001).
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The research was conceptualized by Yukun Lan. The methodology was developed by Yukun Lan and Wenchuan Liu. The investigation was conducted by Yukun Lan. Software development and validation were performed by Yukun Lan, Shuaikang Chang, and Gui Qiang. Data curation was carried out by Yukun Lan and Shuaikang Chang. Resources were provided by Jiren Tang and Hong Li. Funding acquisition was secured by Wenchuan Liu and Jiren Tang. Supervision was overseen by Wenchuan Liu, Jiren Tang, and Hong Li. The original draft of the manuscript was written by Yukun Lan, and all authors (Yukun Lan, Wenchuan Liu, Jiren Tang, Hong Li, Shuaikang Chang, and Gui Qiang) participated in the review and editing process.
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The in vitro experiments were approved by Tianjin Jinke Bona Biotechnology Co., Ltd (Tianjin, China) under scientific license SYXK2023-0005 for scientific experimental research.
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Lan, Y., Liu, W., Tang, J. et al. Investigation on the cutting-infiltration integrated strategy based on medical waterjet for targeted drug delivery. Sci Rep (2026). https://doi.org/10.1038/s41598-026-39721-y
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DOI: https://doi.org/10.1038/s41598-026-39721-y
