Steady-state versus burst lasing techniques for thulium fiber laser.

OBJECTIVE: To evaluate the stone ablation rate and direct thermal damage from thulium fiber laser (TFL) lithotripsy using continuous (C) and burst (B) lasing techniques on an in vitro ureteral model. METHODS: The TFL Drive (Coloplast, Humlebaek, Denmark) was used in an in vitro saline-submerged ureteral model. Ten participants, including five junior and five experienced urologists, conducted the experimental setup with 7 different settings comparing two lasing techniques: steady-state lasing (0.5 J/10 Hz = 5W for 300 s and 0.5 J/20 Hz = 10W for 150 s) and burst, intermittent 5 s on/off lasing (0.5 J/20 Hz, 0.5 J/30 Hz, 0.5 J/60 Hz, 0.1 J/200 Hz, and 0.05 J/400 Hz) with a target cumulative energy of 1500 J using cubic 125 mm3 phantom BegoStonesTM. Ureteral damage was graded 1-3 based on the severity of burns and holes observed on the surface of the ureteral model. RESULTS: The were no significant differences in stone ablation mass neither between C and B lasing techniques, nor between expertise levels. At C lasing technique had only mild ureteral lesions with no significant differences between expertise levels (p: 0.97) or laser settings (p: 0.71). At B lasing technique, different types of thermal lesions were found with no expertise (p: 0.11) or setting (p: 0.83) differences. However, B laser setting had higher grade direct thermal lesions than C (p: 0.048). CONCLUSION: Regarding efficacy, C and B lasing techniques achieve comparable stone ablation rates. Safety-wise, B lasing mode showed higher grade of direct thermal lesions. These results should be further investigated to verify which of the lasing mode is the safest in vivo. Until then and unless proven otherwise, a C mode with low frequency should be recommended to avoid ureteral wall lesions.

Subminute thermal damage to cell types present in the skin.

INTRODUCTION: Psoriasis is characterized by an increase in the proliferation of keratinocytes and nerve fiber activity, contributing to the typical skin lesions. Pulsed Dye Laser (PDL) treatment is effective for the treatment of psoriatic lesions but its mechanism remains unclear. One hypothesis is that PDL causes thermal damage by the diffusion of heat to neighboring structures in lesional skin. There is limited information on the thermal sensitivity of these neighboring skin cells when exposed to hyperthermia for durations lasting less than a minute. Our study aimed to investigate the cell-specific responses to heat using sub-minute exposure times and moderate to ablative hyperthermia. MATERIALS AND METHODS: Cultured human endothelial cells, smooth muscle cells, neuronal cells, and keratinocytes were exposed to various time (2-20 sec) and temperature (45-70 °C) combinations. Cell viability was assessed by measuring intracellular ATP content 24 h after thermal exposure and this data was used to calculate fit parameters for the Arrhenius model and CEM43 calculations. RESULTS: Our results show significant differences in cell survival between cell types (p < 0.0001). Especially within the range of 50-60 °C, survival of neuronal cells and keratinocytes was significantly less than that of endothelial and smooth muscle cells. No statistically significant difference was found in the lethal dose (LT50) of thermal energy between neuronal cells and keratinocytes. However, CEM43 calculations showed significant differences between all four cell types. CONCLUSION: The results imply that there is a cell-type-dependent sensitivity to thermal damage which suggests that neuronal cells and keratinocytes are particularly susceptible to diffusing heat from laser treatment. Damage to these cells may aid in modulating the neuro-inflammatory pathways in psoriasis. These data provide insight into the potential mechanisms of PDL therapy for psoriasis and advance our understanding of how thermal effects may play a role in its effectiveness.

Coupled thermo-mechanical interaction on a multi-layered skin tissue with temperature-dependent physical properties irradiated by a pulse laser.

A detailed understanding of the coupled thermo-mechanical interaction on the biological tissue irradiated by a pulse laser is essential for the existed therapeutic methods constructed on the photo-thermal effect, which will contribute to the design, characterization and optimization of strategies for delivering better treatment. The aim of present work is to explore the coupled thermo-mechanical behavior of a multi-layered skin tissue with temperature-dependent physical properties under the pulsed laser irradiation. A layered theoretical model involved variable physical parameters with temperature has been proposed firstly according to the generalized theory of thermo-elasticity with dual-phase lag mechanism. The numerical method based on an explicit finite difference scheme is then employed to predict the temporal and spatial distributions of the temperature, thermal deformation and stresses experienced to a short-pulse laser irradiation. On this basis, the effect of variable thermal and mechanical physical parameters of skin tissue on the coupled thermo-mechanical behavior and relative thermal damage has been evaluated.

A novel electrode for reducing tissue thermal damage in radiofrequency-induced intestinal anastomosis.

PURPOSE: This study aimed to design a novel electrode for reducing tissue thermal damage in radiofrequency-induced intestinal anastomosis. MATERIAL AND METHODS: We developed and compared two electrodes (Ring electrode, and Plum electrode with reduced section of the middle fusion area by nearly 80% arising from novel structural design) by performing ex-vivo experiments and finite element analysis. RESULTS: In contrast to the Ring electrode group, slightly higher mean strength is acquired with the tensile force and burst pressure results increasing from 9.7 ± 1.47 N, 84.0 ± 5.99 mmHg to 11.1 ± 1.71 N, 89.4 ± 6.60 mmHg, respectively, as well as a significant reduction in tissue thermal damage for the Plum electrode group, with compression pressure of 20 kPa, RF energy of 120 W and welding duration of 8 s applied to the target regions to achieve anastomosis. Besides, the novel structural design of the Plum electrode can counteract the tension generated by intestinal peristalsis and enhance the biomechanical strength of the anastomotic area. The histological observation showed that the fusion area of the two-layer intestinal tissue is tightly connected with decreased thickness. CONCLUSION: The novel electrode (Plum electrode) could reduce tissue thermal damage in radiofrequency-induced intestinal anastomosis.

A novel discrete linkage-type electrode for radiofrequency-induced intestinal anastomosis.

INTRODUCTION: For decades, radiofrequency (RF)-induced tissue fusion has garnered great attention due to its potential to replace sutures and staples for anastomosis of tissue reconstruction. However, the complexities of achieving high bonding strength and reducing excessive thermal damage present substantial limitations of existing fusion devices. MATERIALS AND METHODS: This study proposed a discrete linkage-type electrode to carry out ex vivo RF-induced intestinal anastomosis experiments. The anastomotic strength was examined by burst pressure and shear strength test. The degree of thermal damage was monitored through an infrared thermal imager. And the anastomotic stoma fused by the electrode was further investigated through histopathological and ultrastructural observation. RESULTS: The burst pressure and shear strength of anastomotic tissue can reach 62.2 ± 3.08 mmHg and 8.73 ± 1.11N, respectively, when the pressure, power and duration are 995 kPa, 160 W and 13 s, and the thermal damage can be controlled within limits. Histopathological and ultrastructural observation indicate that an intact and fully fused stomas with collagenic crosslink can be formed. CONCLUSION: The discrete linkage-type electrode presents favorable efficiency and security in RF-induced tissue fusion, and these results are informative to the design of electrosurgical medical devices with controllable pressure and energy delivery.

Histological damage characteristics and quantitive analysis of porcine skin with non-insulated microneedle radiofrequency.

OBJECTIVE: In recent years, the microneedle radiofrequency (MRF) has been widely used for skin rejuvenation, but histological studies on the immediate trauma caused by different parameters of non-insulated RF microneedles METHODS: The skin of three pigs was treated with different needle depths, pulse widths and energy levels of non-insulated microneedle RF. Samples were collected before, immediately, and 2 weeks after treatment. The immediate histological response of each group was assessed and quantified by hematoxylin and eosin staining, Masson staining and Victoria Blue staining. RESULTS: In the treatment of non-insulated microneedle RF, different energy levels affected mainly the range of thermal damage (p = 0.044), and different needle depths affected mainly the depth of the cavity (p = 0.022). But the width of the coagulation zone width was determined by different factors. There was no significant difference in the histology of immediate damage caused by different pulse widths. Reepithelialization of the epidermis and basic wound repair can be completed within 2 weeks. CONCLUSION: Non-insulated RF microneedle therapy is an effective and safe treatment that can stimulate dermal wound healing with less thermal coagulation and a wide range of reversible thermal damage. However, it should be noted that the set needle depth may not correspond to the actual penetration depth, nor to the actual depth of histologic trauma.

Evaluation of cutting efficiency and thermal damage during soft tissue surgery with 940 nm-diode laser: An ex vivo study.

OBJECTIVES: To investigate quantitatively the cutting efficiency and the thermal effects in the surrounding soft tissues of incisions that are induced by a 940 nm-diode laser with different power settings. MATERIALS AND METHODS: Fifty-four gingival samples were prepared from the lower jaws of freshly slaughtered German-land race pigs and were randomly divided into 9 groups (n = 6) according to the adjusted output power (1, 1.5, 2, 2.5, 3, 3.5, 4, 5 and 6 W). Five incisions were implemented for each sample using a diode laser (940 nm) in continuous wave with an initiated tip resulting in 30 incisions for each experimental group utilizing a three-dimensional computer-controlled micropositioner. The samples were prepared for histometric evaluation using a transmitted light microscope. The cutting depth and width and the thermal damage were recorded for each sample and the efficiency factor γ was calculated. RESULTS: The highest cutting efficiency (γz = 0.81 ± 0.03) exhibited the group with 5 W output power (p < 0.05), while the lowest (γz = 0.45 ± 0.11) showed the 1-W group (p < 0.05). Over 3.5 W there was a rapid increase in the size of thermal damage of the incisions, especially for 6 W, which presented the largest. CONCLUSIONS: The most effective power parameters of diode laser (940 nm) for soft tissue surgery were from 3 to 5 W. The outcomes of the current study may help to establish clinical protocols for the use of diode lasers (940 nm) in soft tissue surgery in contact mode assisting dental professionals to achieve optimal clinical results and avoid complications.

Non-Contact Irreversible Electroporation in the Esophagus With a Wet Electrode Approach.

Our objective was to develop a technique for performing irreversible electroporation (IRE) of esophageal tumors while mitigating thermal damage to the healthy lumen wall. We investigated noncontact IRE using a wet electrode approach for tumor ablation in a human esophagus with finite element models for electric field distribution, joule heating, thermal flux, and metabolic heat generation. Simulation results indicated the feasibility of tumor ablation in the esophagus using an catheter mounted electrode immersed in diluted saline. The ablation size was clinically relevant, with substantially lesser thermal damage to the healthy esophageal wall when compared to IRE performed by placing a monopolar electrode directly into the tumor. Additional simulations were used to estimate ablation size and penetration during noncontact wet-electrode IRE (wIRE) in the healthy swine esophagus. A novel catheter electrode was manufactured and wIRE evaluated in seven pigs. wIRE was performed by securing the device in the esophagus and using diluted saline to isolate the electrode from the esophageal wall while providing electric contact. Computed tomography and fluoroscopy were performed post-treatment to document acute lumen patency. Animals were sacrificed within four hours following treatment for histologic analysis of the treated esophagus. The procedure was safely completed in all animals; post-treatment imaging revealed intact esophageal lumen. The ablations were visually distinct on gross pathology, demonstrating full thickness, circumferential regions of cell death (3.52 ± 0.89 mm depth). Acute histologic changes were not evident in nerves or extracellular matrix architecture within the treatment site. Catheter directed noncontact IRE is feasible for performing penetrative ablations in the esophagus while avoiding thermal damage.

Thermal damage and the prognostic evaluation of laser ablation of bone tissue-a review.

In recent years, an increasing number of scientists have focused on conducting experiments on laser ablation of bone tissue. The purpose of this study was to summarize the prognosis of tissue and the extent of thermal damage in past hard tissue ablation experiments, and review the evidence for the feasibility of laser osteotomy in surgery. An electronic search of PubMed, China National Knowledge Infrastructure (CNKI), and Web of Science (WOS) for relevant English-language articles published through June 2023 was conducted. This review includes 48 literature reports on laser ablation of hard tissues from medical and biological perspectives. It summarizes previous studies in which the ideal ablation rate, depth of ablation, and minimal damage to bone tissue and surrounding soft tissues were achieved by changing the laser type, optimizing the laser parameter settings, or adding adjuvant devices. By observing their post-operative healing and inflammatory response, this review aims to provide a better understanding of pulsed laser ablation of hard tissues. Previous studies suggest that laser osteotomy has yielded encouraging results in bone resection procedures. We believe that low or even no thermal damage can be achieved by experimentally selecting a suitable laser type, optimizing laser parameters such as pulse duration and frequency, or adding additional auxiliary cooling devices. However, the lack of clinical studies makes it difficult to conclusively determine whether laser osteotomy is superior in clinical applications.

Development of Laser Processing Carbon-Fiber-Reinforced Plastic.

Due to its exceptional advantages, such as high specific strength, high specific modulus, and good fatigue resistance, carbon-fiber-reinforced plastic (CFRP) is frequently utilized in aerospace, aviation, automotive, rail transportation, and other areas. Composite components typically need to be joined and integrated. In the equipment manufacturing industry, the most used methods for processing composite components are cutting, drilling, and surface treatment. The quality of CFRP is significantly impacted by traditional mechanical processing, causing flaws like delamination, burrs, and tears. Laser processing technology has emerged as a crucial method for processing CFRP for its high quality, non-contact, simple control, and automation features. The most recent research on the laser processing of CFRP is presented in this paper, supporting scientists and engineers who work in the field in using this unconventional manufacturing technique. This paper gives a general overview of the key features of laser processing technology and the numerous machining techniques available. The concepts and benefits of laser processing technology are discussed in terms of the material properties, mode of operation, and laser characteristics, as well as the methods to achieve high efficiency, low damage, and high precision. This paper reviews the research development of laser processing of carbon-fiber-reinforced plastics, and a summary of the factors affecting the quality of CFRP laser processing. Therefore, the research content of this article can be used as a theoretical basis for reducing thermal damage and improving the processing quality of laser-processed composite materials, while, on this basis, we analyze the development trend of CFRP laser processing technology.