Giesen Christina, Jarry Elisa, Bochvarov Lazar, Lenenbach Achim
Fraunhofer Institute for Laser Technology, Aachen, Germany.
J Biomed Opt. 2025 Jul;30(7):078001. doi: 10.1117/1.JBO.30.7.078001. Epub 2025 Jul 16.
In neurosurgery, where operations take place near tissue structures with high functionality, precise devices for microsurgical procedures such as blood vessel coagulation are crucial. Currently, bipolar forceps that deliver up to 60 W with high alternating current are used for vascular coagulation (hemostasis) to thermally seal blood vessels and stop bleeding. However, the high current can disturb electrophysiological monitoring and cause nerve damage from heat spread.
Therefore, a safer and more efficient microsurgical procedure is required to seal individual blood vessels.
Our approach uses a wavelength of 454 nm, which closely matches the hemoglobin absorption peak to directly heat the blood and avoid thermal damage to surrounding tissue. In experiments on blood vessels at the vascular tree of pig hearts, occlusion rates of different vessel diameters, the thermal damage, and the dynamics of the coagulation process using optical coherence tomography were investigated.
Our findings show that laser radiation of 454 nm wavelength can reliably coagulate vessels up to in diameter with small thermal damage zones. Further research will be necessary to occlude larger vessels with a blood pressure of more than 120 mmHg.
Overall, we present a laser process that can fundamentally improve the safety and operation time in neurosurgical interventions.
在神经外科手术中，手术操作靠近具有高功能的组织结构，用于血管凝固等显微外科手术的精确设备至关重要。目前，用于血管凝固（止血）以热封闭血管并止血的是输送高达60瓦高交流电的双极镊子。然而，高电流会干扰电生理监测并因热扩散导致神经损伤。
因此，需要一种更安全、更高效的显微外科手术来封闭单个血管。
我们的方法使用波长为454纳米的光，该波长与血红蛋白吸收峰紧密匹配，可直接加热血液并避免对周围组织造成热损伤。在猪心脏血管树的血管实验中，研究了不同血管直径的闭塞率、热损伤以及使用光学相干断层扫描的凝固过程动态。
我们的研究结果表明，波长为454纳米的激光辐射能够可靠地凝固直径达[具体直径数值缺失]的血管，热损伤区域较小。对于血压超过120毫米汞柱的较大血管进行闭塞，还需要进一步研究。
总体而言，我们提出了一种激光方法，可从根本上提高神经外科手术干预的安全性和手术时间。
