研究目的
The aim of the current study was to identify the efficient fiber movements for 532-nm laser prostatectomy.
研究成果
The current study demonstrated that the most efficient ablation performance occurred at a TS of 2 mm/s and an RS of 1.0 rad/s in ex vivo kidney models. The fiber movements in association with longer interaction times were critical to enhance the overall ablation performance. Further studies will validate the current findings with higher power levels in ex vivo and in vivo laser prostatectomy.
研究不足
As prostate consists of glandular and stromal tissue, kidney tissue is mainly glandular, which may hardly reflect collagen denaturation during laser ablation. Once collagen is thermally denatured, the degree of light absorption can decrease, but scattering effect can be augmented instead. Thus, the resulting coagulated tissue may need higher laser energy and/or different fiber movement techniques to maintain the ablation efficiency. In addition, the kidney tissue was procured from animal cadavers, so its ischemic feature may lead to different tissue responses to 532 nm laser irradiation. Thus, further tests with in vivo prostate tissue will be essential to clinical relevance of the current findings.
1：Experimental Design and Method Selection:
The study tested 532-nm Lithium triborate (LBO) laser light on 120 kidney tissues at three different translational speeds (TS 1, 2, and 4 mm/s) and four different rotational speeds (RS
2：5, 0, 6, and 1 rad/s). The applied power was 120 W at a 2-mm working distance and 60° sweeping angle. Sample Selection and Data Sources:
Porcine kidney tissue was used for the current ex vivo testing because of easy tissue procurement, homogeneous structure, and consistent quantification.
3：List of Experimental Equipment and Materials:
A clinical 532 nm laser system (GreenLight XPS?, Boston Scientific, Corp., San Jose, CA) was implemented to ablate kidney tissue at 120 W using a 750-μm core-diameter side-firing fiber (Moxy?, Boston, Scientific, Corp., San Jose, CA).
4：Experimental Procedures and Operational Workflow:
Laser light was irradiated on the exposed flat surface through the aperture. A customized three-dimensional motion controller was employed to adjust the relative linear movement (TS) of an optical fiber over the tissue (x-axis). The distal fiber tip was initially positioned 2 mm above the targeted tissue (z-axis). A protractor was installed at the proximal end of the fiber to maintain a sweeping angle of 60° during the irradiation. A metronome was also used to control various RSs manually.
5：Data Analysis Methods:
After testing, all samples were cross-sectioned into ten specimens (1-mm thick) to evaluate ablation rate and dimensions of ablation craters. The ablated area of each specimen was measured using Image J (National Institute of Health, Bethesda, MD). All the measured areas were integrated to quantify the resulting ablation volume. The ablation rate was then calculated by dividing the volume by the corresponding irradiation time.
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