Seitz Michael, Bayer Thomas, Ruszat Robin, Tilki Derya, Bachmann Alexander, Gratzke Christian, Schlenker Boris, Stief Christian, Sroka Ronald, Reich Oliver
Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians-University Munich, Germany.
BJU Int. 2009 Mar;103(6):770-5. doi: 10.1111/j.1464-410X.2008.08066.x. Epub 2008 Oct 16.
To evaluate, ex vivo and in vivo, the tissue-removal capacity and coagulation properties of a diode laser emitting light at 940 nm, as in the search for potential therapeutic strategies for benign prostatic hyperplasia that cause less morbidity than transurethral resection of the prostate (TURP), various types of lasers have been tested.
A diode laser system (prototype; wavelength 940 nm, Dornier MedTech, Wessling, Germany) was evaluated in an isolated, blood-perfused ex-vivo porcine kidney model at 10-60 W (five kidneys). An in-vivo beagle model was used to investigate the effects on six prostate lobes at a generator output power level of 200 W. After the laser treatment tissue were examined histologically to compare the depth of coagulation and vaporization.
With increasing generator output power levels there was an increasing vaporization and coagulation ability for the diode laser at 940 nm in the ex-vivo model. At 60 W the mean (sd) vaporization depth was 1.72 (0.47) mm with a coagulation zone of 9.56 (0.26) mm. In vivo, the diode laser caused rapid ablation with no intraoperative haemorrhage. Histologically, the zone of coagulation had a mean (sd) depth of 4.25 (0.15) mm at 200 W. The tissue removal capacity was estimated at 0.874-1.583 g/min in vivo.
Our findings indicate that diode-laser vaporization at 940 nm is feasible and might be effective for acutely relieving bladder outlet obstruction in an in-vivo setting. Due to its mean coagulation zone of 4.25 mm the diode laser seems to have effective haemostatic properties.
在体外和体内评估发射940nm波长光的二极管激光的组织切除能力和凝血特性，由于在寻找比经尿道前列腺切除术（TURP）发病率更低的良性前列腺增生潜在治疗策略时，已经测试了各种类型的激光。
在一个离体、血液灌注的猪肾模型中，以10 - 60W的功率（五个肾脏）评估一个二极管激光系统（原型；波长940nm，德国韦斯林多尼尔医疗技术公司）。使用体内比格犬模型，在发生器输出功率水平为200W时研究对六个前列腺叶的影响。激光治疗后，对组织进行组织学检查，以比较凝血和汽化深度。
在体外模型中，随着发生器输出功率水平的增加，940nm二极管激光的汽化和凝血能力增强。在60W时，平均（标准差）汽化深度为1.72（0.47）mm，凝血区为9.56（0.26）mm。在体内，二极管激光导致快速消融且术中无出血。组织学检查显示，在200W时，凝血区平均（标准差）深度为4.25（0.15）mm。体内组织切除能力估计为0.874 - 1.583g/分钟。
我们的研究结果表明，940nm二极管激光汽化在体内环境中是可行的，可能对急性缓解膀胱出口梗阻有效。由于其平均凝血区为4.25mm，二极管激光似乎具有有效的止血特性。
