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A 2-km Continuous-Wave Laser System for Safe and High-Precision Dissection During NOTES Procedures
Ist Teil von
Digestive diseases and sciences, 2010-09, Vol.55 (9), p.2463-2470
Erscheinungsjahr
2010
Quelle
SpringerLink
Beschreibungen/Notizen
Introduction: Lasers 2-km in wavelength offer efficient tissue cutting with limited thermal damage in biological tissue. Objective: To evaluate the dissection capabilities of a 2-km continuous-wave laser for NOTES procedures. Methods and Procedures: We conducted 18 acute animal experiments. Group 1 (three animals): transcolonic access to the peritoneal cavity (15-W transcolonic laser puncture, balloon dilation over the laser probe). Group 2 (six animals): transcolonic access with needle-knife puncture and balloon dilation. Group 3 (three animals): transgastric access to the peritoneal cavity (similar technique as group 1) followed by laser-assisted dissection of the kidney. In one animal of group 3, a therapeutic target (hematoma) was created by percutaneous puncture of the kidney. Group 4 (six animals): transgastric access (similar to the technique of group 2). Results: Translumenal access to the peritoneal cavity was achieved in 2-3min in group 1 (significantly shorter than with the needle-knife-assisted technique, 4-5min, p=0.02) and in 7-10min in group 3 (compared to 6-17min in group 4, p=0.88). In group 3, laser dissection of the parietal peritoneum and of perinephric connective tissue allowed access to the retroperitoneum with complete removal of a blood collection in the animal with puncture trauma. Laser dissection demonstrated good maneuverability, clean and rapid cutting, and excellent hemostasis. Peritoneoscopy and necropsy showed no damage of targeted tissue and surrounding organs. Conclusions: The 2-km continuous-wave laser system showed promising capabilities for highly precise and safe dissection during NOTES procedures.
Sprache
Englisch
Identifikatoren
ISSN: 0163-2116
eISSN: 1573-2568
DOI: 10.1007/s10620-010-1214-5
Titel-ID: cdi_proquest_miscellaneous_853480637
Format
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