ABSTRACT
In an ex vivo- and an animal study a Holmium-YAG laser, a Nd:YAG laser and a CO2 laser were examined. For laparoscopic cholecystectomy the pulsed Holmium:YAG laser proved to be the best instrument. Dissecting and haemostatic effects were connected when working with a power of 4 watts. Dissected area per minute was 112 mm2, gallbladder dissection (15 cm2) can be performed in 13 min. In the animal study the cholecystectomy lasted 30 min on average when the Holmium:YAG laser was used. Bleeding was not observed, development of smoke was tolerable.
Subject(s)
Cholecystectomy, Laparoscopic/instrumentation , Laser Therapy/instrumentation , Equipment Design , Equipment Failure , Female , Gallbladder/pathology , Hemostasis, Surgical/instrumentation , Humans , Liver/pathology , Necrosis , Tissue AdhesionsABSTRACT
Laser induced shockwave lithotripsy (LISL) on artificially inserted human renal calculi was realized in explanted pig ureters. A pulse stretched Alexandrite solid state laser was used at 750nm. Pulses of 350ns and 1 microseconds duration were transmitted through a 250 microns all silica fiber onto a stone surface, keeping the fiber tip in contact with a stone close to the ureter wall. The high power density of the 350 ns pulses lead to an optical breakdown inside the distal fiber tip causing fiber fragmentation of about 28 mm/100 pulses. Deep penetration of the fiber fragments into the ureter wall was proven histologically. Fiber fragmentation was avoided by increasing the pulse duration up to 1 microseconds. Riks for patient treatment caused by short pulse lithotripsy are discussed.