Feasibility and safety assessment of endoscopic laser therapy (ELT) for duodenal mucosal ablation in a porcine model.

The current study aims to assess the feasibility and safety of using endoscopic laser therapy (ELT) to ablate duodenal mucosa in a porcine model. A new endoscopic laser catheter (ELC) was developed to enable circumferential laser ablation of tubular tissue structures for ELT. Both ex vivo and in vivo porcine duodenal tissues were evaluated using a diode laser emitting laser light at 100 J to quantitatively assess thermal distribution and tissue response. In vivo porcine models were used to validate the performance of the ELT in achieving selective mucosal ablation. Assessments were performed at both acute (D0) and chronic (D28) time points after ablation. Ex vivo experimental results showed that the maximum temperature increase occurred at the mucosal surface after laser irradiation, while the minimum temperature increase occurred at the muscle layer. Endoscopic imaging confirmed that the ELC successfully produced uniform circumferential thermal damage around the mucosal surface. In vivo results confirmed selective mucosal ablation without thermal damage to the submucosa or muscular layers in both short- and long-term assessments. Therefore, the proposed ELT may have a therapeutic capacity for remodeling the duodenal mucosa in metabolic disease applications.