Fournier G R, Kung A H, Trost D
Division of Urology, Crawford Long Hospital, Emory University, Atlanta, Georgia 30308, USA.
Lasers Surg Med. 1995;16(4):390-6. doi: 10.1002/lsm.1900160411.
The CO2 laser is potentially useful for the surgical treatment of superficial bladder tumors. High water absorption of the CO2 laser beam and the lack of a flexible fiber delivery system has hindered development of cystoscopes designed to evaporate bladder tumors. This report describes a cystoscope capable of delivering a high-power CO2 laser beam to all parts of the urinary bladder.
STUDY DESIGN/MATERIALS AND METHODS: A rigid 24 Fr. cystoscope transmitting 80 Watts of power via an articulated arm and infrared waveguide was built. Beam manipulation is by reflection using a movable mirror. Smoke and urine are evacuated by continuous flow of CO2 purge gas. An isotopic laser delivering an 11.1 micron wavelength beam prevents resonant absorption. Conventional 30-70 degrees telescopes are used. Scope performance and lesion morphology were tested in four female pigs.
A total of 80-85% of the incident energy is delivered to the mucosa. All areas of the bladder mucosa can be evaporated. All components tolerate wetting. Mucosa and lamina propria are evaporated with 30 Joules of delivered energy. Perforation occurs after 120-160 Joules are delivered to a single spot.
The limitations of power, beam transmission, beam manipulation within a small cavity, and resistance to wetting have been overcome.
二氧化碳激光在浅表膀胱肿瘤的外科治疗中具有潜在应用价值。二氧化碳激光束的高吸水性以及缺乏灵活的光纤传输系统阻碍了旨在汽化膀胱肿瘤的膀胱镜的发展。本报告描述了一种能够将高功率二氧化碳激光束传输至膀胱各个部位的膀胱镜。
研究设计/材料与方法：制造了一种通过关节臂和红外波导传输80瓦功率的24F刚性膀胱镜。通过使用可移动反射镜反射来操控光束。通过持续流动的二氧化碳吹扫气体排出烟雾和尿液。一种发射11.1微米波长光束的同位素激光可防止共振吸收。使用传统的30 - 70度望远镜。在四只雌性猪身上测试了膀胱镜性能和病变形态。
总共80 - 85%的入射能量传递至黏膜。膀胱黏膜的所有区域均可被汽化。所有部件均能耐受浸湿。传递30焦耳能量后可汽化黏膜和固有层。向单个部位传递120 - 160焦耳能量后会发生穿孔。
已克服了功率、光束传输、小腔内光束操控以及耐湿性方面的限制。
