PDF(Pubmed)
Abstract：
Electrosurgical and ultrasonic devices are used in surgical procedures for hemostatic sealing and bisection of vascular tissues. Previous benchtop studies alternatively demonstrated successful infrared laser sealing and cutting of blood vessels, in a sequential, two-step approach. This study describes a smaller, laparoscopic device compatible design, and simultaneous approach to sealing and bisection of vessels, with potential optical feedback. A 1470-nm infrared diode laser sealed and bisected 40 porcine renal arteries, ex vivo. A reciprocating, side-firing, optical fiber, housed in a transparent square quartz optical chamber (2.7 × 2.7 × 25 mm outer dimensions), delivered laser energy over an 11 mm scan length, with a range of incident powers (41-59 W) and treatment times (5-21 s). Vessel diameters ranged from 2.5 to 4.8 mm. Vessel burst pressure measurements were performed on each cut end (n = 80) with success indicated by pressures exceeding 360 mmHg. All vessel ends were successfully sealed and bisected (80/80). The highest incident power, 59 W, yielded short treatment times of 5-6 s. Peak temperatures on the external chamber surface reached 103 oC. Time to cool down to body temperature measured 37 s. Infrared lasers simultaneously seal and bisect blood vessels, with treatment times comparable to, and temperatures and cooling times lower than reported for conventional devices. Future work will focus on integrating the fiber and chamber into a standard 5-mm-outer-diameter laparoscopic device. Customization of fiber scan length to match vessel size may also reduce laser energy deposition, enabling lower peak temperatures, treatment times, and cooling times.
摘要：
电外科和超声装置在外科手术中用于血管组织的止血密封和平分。先前的台式研究也证明了成功的红外激光密封和切割血管，在一个连续的，两步法。这项研究描述了一个较小的，腹腔镜设备兼容设计，同时封闭和平分血管，具有潜在的光学反馈。1470nm红外二极管激光器密封并平分了40条猪肾动脉，离体。一个往复的，侧面发射,光纤,装在一个透明的方形石英光学室（2.7×2.7×25毫米的外部尺寸），在11毫米的扫描长度上传递激光能量，具有一定范围的入射功率（41-59W）和治疗时间（5-21s）。容器直径范围为2.5至4.8mm。在每个切割端（n=80）进行容器破裂压力测量，成功的压力超过360mmHg。成功地密封并平分(80/80)所有容器端。最高的入射功率，59W,产生5-6s的短处理时间。外室表面的峰值温度达到103oC。冷却到体温的时间测量为37秒。红外激光同时密封和平分血管，与治疗时间相当，温度和冷却时间低于传统设备的报告。未来的工作将集中在将纤维和腔室集成到标准的5毫米外径腹腔镜设备中。定制光纤扫描长度以匹配血管尺寸还可以减少激光能量沉积，实现较低的峰值温度，治疗次数,和冷却时间。
