Li Zhilong, Wu Shaojie, Tang Xiaoyu, Zuo Yingtong, Liu Tongzu, Wang Du, Li Sheng, Wang Xinghuan
Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
Department of Urology, Cancer Precision Diagnosis and Treatment and Translational Medicine Hubei Engineering Research Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, China.
Lasers Med Sci. 2025 Feb 25;40(1):118. doi: 10.1007/s10103-025-04375-1.
There is a lack of clinical consensus on the parameter settings of the pulsed-wave thulium fiber laser for soft tissue resection. The aim of this study was to explore the optimal parameter settings of the pulsed-wave thulium fiber laser for soft tissue resection, with a view to providing a reference for future clinical applications. Two different thulium fiber lasers, prototype thulium fiber lasers and Urolase, were used to explore the optimal parameters of thulium fiber laser for soft tissue cutting by evaluating the depth of tissue vaporization and depth of thermal damage in an isolated pig kidney model, and then the optimal parameters of in vitro screening were statistically validated by operation time, coagulation time, intraoperative hemorrhage, smoke level, and depth of thermal damage in an in vivo model using rabbit kidney. In ex vivo animal experiments the depth of tissue vaporization and thermal damage increased with increasing average power, and tissue carbonization occurred at 30 W. In animal use we used 1 J, 25 W for surgery, and there was no statistical difference between the two thulium fiber lasers in terms of surgery time, coagulation time, bleeding, smoke level, and depth of thermal damage. Thulium fiber laser for soft tissue resection is safe and feasible, and we believe that 1 J, 25 W is the optimal laser setting parameter for soft tissue resection, but it needs to be adjusted according to the actual situation.
对于软组织切除的脉冲波铥光纤激光器的参数设置，临床尚未达成共识。本研究的目的是探索软组织切除的脉冲波铥光纤激光器的最佳参数设置，以期为未来的临床应用提供参考。使用两种不同的铥光纤激光器，即原型铥光纤激光器和Urolase，通过在离体猪肾模型中评估组织汽化深度和热损伤深度，来探索铥光纤激光器用于软组织切割的最佳参数，然后通过在兔肾体内模型中的手术时间、凝血时间、术中出血、烟雾水平和热损伤深度，对体外筛选出的最佳参数进行统计学验证。在离体动物实验中，组织汽化深度和热损伤随平均功率的增加而增加，在30W时出现组织碳化。在动物实验中，我们使用1J、25W进行手术，两种铥光纤激光器在手术时间、凝血时间、出血、烟雾水平和热损伤深度方面没有统计学差异。铥光纤激光器用于软组织切除是安全可行的，我们认为1J、25W是软组织切除的最佳激光设置参数，但需要根据实际情况进行调整。
