Background:
Pulsed water jet dissection is an emerging surgical method for dissection with preservation of vessels and ducts. The purpose of present study is to elucidate the dissection profile of the novel piezo actuator-driven pulsed water jet and to clarify the mechanism of dissection with tissue selectivity.

Material and Methods:
This system comprised a pump chamber driven by a piezo actuator, stainless steel tube, and nozzle. The peak pressure of pulsed water jet was measured through a sensing hole using a pressure sensor. The physical properties of swine liver were measured using table-top universal testing instruments. Pulsed water jet was irradiated in swine liver on the moving table and dissection depth was measured by light microscopy and evaluated histologically.

Result:
The peak pressure of the pulsed water jet was positively correlated with the input voltage (R2 = 0.9982, P < 0.0001) and also reflected in the dissection depth. The dissection depth was negatively correlated with the breaking strength (R2 = 0.6694, P < 0.0001). Histological staining revealed that the liver parenchyma was dissected while preserving the hepatic veins and Glisson’s sheaths in contrast to the electrocautery or ultrasonic instrument.

Conclusion:
Dissection depth is dependent on input voltage, moving velocity, and physical property of organ to be dissected. The breaking strength of the liver parenchyma was significantly lower than that of Glisson’s sheaths and the hepatic veins. The device has possibility of assuring liver resection with tissue selectivity, preservation of hepatic veins, and Glisson’s sheaths because of their different physical properties.