Experience in non-contact Nd YAG laser in pulmonary surgery. A pilot study.

This paper presents our experience and the results of a pilot study in non-contact Nd YAG laser in pulmonary surgery. During an 18-month period laser was used in 43 patients undergoing pulmonary surgery. All patients had a thoracotomy using a conventional surgical technique but the laser was employed for the pulmonary operation. The laser equipment consisted of Pilkington Fibrelase 100, delivering 10-100 watts energy in pulses of 1-9 s. The laser energy was applied using our sterile applicator and as a non-contact mode. Seven patients (group 1) had "coin" pulmonary lesions excised solely by laser evaporation and fulguration of 0.5-1 cm around the margin of the lesion. In 24 patients (group 2) laser was used in conjunction with conventional surgery in order to excise the residual disease and to provide better clearance with less loss of healthy parenchyma. In 17 patients (group 3) the laser was used to dispose of lymph nodes which were inaccessible for resection by conventional surgical methods. In 8 patients (group 4) laser was used for the purpose of haemostasis. Some patients in groups 2, 3 and 4 fell into categories other than that of their defined groups. There was no mortality or morbidity associated with the laser in these patients. This experience indicates the potential usefulness of laser in lung surgery and its particular value in pulmonary "coin" lesions and in association with conventional surgery in order to achieve conservative lung resection.