研究目的
To evaluate the feasibility of using a novel blue diode laser, a thulium fiber laser, and their combination as a directed‐energy surgical tool in laparoscopic partial nephrectomy (LPN).
研究成果
The blue diode laser and the combination of blue and thulium fiber lasers present a novel and efficient alternative for laparoscopic partial nephrectomy, offering fast cutting with minimal carbonization and acceptable hemostasis. The dual laser system shows promise for reducing operation time and improving surgical outcomes.
研究不足
The study was limited by a small sample size for in vivo LPN (one resection per laser/laser combination), subjective estimation of blood loss, and lack of follow-up on the healing process. The surgeon's experience may have influenced the outcomes.
1:Experimental Design and Method Selection
The study tested the blue diode laser emitting at 442 nm, the thulium fiber laser emitting at 1,940 nm, and their combination for their cutting and coagulative abilities on porcine kidney ex vivo and in vivo. Histological staining was used to assess ablation and coagulation efficiency.
2:Sample Selection and Data Sources
Fresh porcine kidney was used for ex vivo experiments, and a porcine model was used for in vivo LPN experiments.
3:List of Experimental Equipment and Materials
Blue diode laser (prototype; NTO IRE‐Polus), thulium fiber laser (NTO IRE‐Polus), surgical fibers, motorized stage for controlled fiber movement, NanoScan v2 beam profiler (Ophir Photonics), InGaAs photodiodes (Hamamatsu Photonics), digital oscilloscope (ACK‐6109; Aktakom), LabView software (National Instruments), microtome (3550 TECHNICAL; Genelabotech), ImageJ software (National Institute of Health), Leica RM2125 microtome (Leica Microsystems), microscope LEICA DM4000 B LED with digital camera LEICA DFC7000 T and LAS V4.8 software (Leica Microsystems).
4:Experimental Procedures and Operational Workflow
Ex vivo cutting was performed on porcine kidney in air and CO2 environments. In vivo LPN was performed on a porcine model at zero ischemia. Laser settings were adjusted for optimal cutting and coagulation. Histological analysis was performed to evaluate thermal damage and coagulation zones.
5:Data Analysis Methods
Histological sections were analyzed using ImageJ and LAS V4.8 software. Statistical analysis was performed using GraphPad software for unpaired t-tests.
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NanoScan v2 beam profiler
v2
Ophir Photonics
Measuring the spot size of laser beams
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Leica RM2125 microtome
RM2125
Leica Microsystems
Preparing tissue sections for histological analysis
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microscope LEICA DM4000 B LED
DM4000 B LED
Leica Microsystems
Analyzing histological slides
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digital camera LEICA DFC7000 T
DFC7000 T
Leica Microsystems
Capturing images of histological slides
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blue diode laser
prototype
NTO IRE‐Polus
Surgical tool for laparoscopic partial nephrectomy
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thulium fiber laser
NTO IRE‐Polus
Surgical tool for laparoscopic partial nephrectomy
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InGaAs photodiodes
Hamamatsu Photonics
Measuring temporal pulse shape of lasers
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digital oscilloscope
ACK‐6109
Aktakom
Analyzing pulse shapes of lasers
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microtome
3550 TECHNICAL
Genelabotech
Producing thin sections of tissue for histological analysis
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