Ramli Rahayu, Chung Chia-Chun, Fried Nathaniel M, Franco Nicholas, Hayman Michael H
Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA.
Lasers Surg Med. 2004;35(5):392-6. doi: 10.1002/lsm.20112.
This study investigates deep laser coagulation of tissue in combination with contact cooling of the tissue surface for potential use in noninvasive procedures in urology.
STUDY DESIGN/MATERIALS AND METHODS: A laser probe was designed and tested for simultaneous Nd:YAG laser irradiation and sapphire contact cooling of liver and skin tissue samples, ex vivo. Gross and histologic examination was used to quantify thermal lesion dimensions.
Liver lesions measured 5.5 +/- 0.3 mm in diameter, while preserving the tissue surface to a depth of 2.1 +/- 0.2 mm (n = 5). Skin lesions measured 4.3 +/- 0.9 mm in diameter, while preserving the skin surface to a depth of 1.1 +/- 0.2 mm (n = 6). There were no statistical differences in lesion diameter and layer of preserved tissue between contact (sapphire) cooling and prior non-contact (cryogen spray) cooling results for a given tissue type (P > 0.05).
Noninvasive laser procedures targeting tissue structures for thermal coagulation within a few millimeters of the tissue surface are feasible and may expand the use of combined laser/cooling techniques for applications in urology and general surgery. In vivo animal studies are currently in development to optimize the laser and cooling parameters for potential clinical applications.
本研究探讨组织的深层激光凝固联合组织表面接触式冷却在泌尿外科无创手术中的潜在应用。
研究设计/材料与方法:设计并测试了一种激光探头,用于对肝脏和皮肤组织样本进行体外钕:钇铝石榴石激光照射和蓝宝石接触式冷却。采用大体和组织学检查来量化热损伤尺寸。
肝脏损伤直径为5.5±0.3毫米,同时组织表面保留深度为2.1±0.2毫米(n = 5)。皮肤损伤直径为4.3±0.9毫米,同时皮肤表面保留深度为1.1±0.2毫米(n = 6)。对于给定的组织类型,接触(蓝宝石)冷却和先前非接触(低温喷雾)冷却结果在损伤直径和保留组织层方面无统计学差异(P > 0.05)。
针对组织表面几毫米内组织结构进行热凝固的无创激光手术是可行的,可能会扩大激光/冷却联合技术在泌尿外科和普通外科中的应用。目前正在开展体内动物研究,以优化激光和冷却参数,用于潜在的临床应用。