Precision resection of intestine using ultrashort laser pulses
Precision resection of intestine using ultrashort laser pulses
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使用超短激光脉冲精确切除肠道
DOI：
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
J. Shephard
中科院分区：
文献类型：
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作者：
R. J. Beck;W. Góra;D. Jayne;D. Hand;J. Shephard
早期结直肠肿瘤的内窥镜切除通常使用电灼术工具，这种工具缺乏精确度，并且有可能因随后的穿孔而对肠壁造成全层热损伤。我们提出了一种使用皮秒激光脉冲的腔内结肠消融方法，作为一种潜在的替代方案来缓解这些限制。高强度的超短激光脉冲能够实现非线性吸收过程，产生等离子体，并因此实现主要的非热消融方案。使用新鲜的体外猪肠样本展示了激光切除的可靠工艺参数。用皮秒激光系统切除与早期结直肠肿瘤厚度相当的方腔，波长分别为1030 nm和515 nm。相应的组织切片显示，在这两种情况下，对周围组织的附带损伤都很小。利用脉冲能量可以精确控制烧蚀深度。总体而言，与传统的电灼术相比，应用超快激光切除肠道可以显著提高精确度，减少对周围组织的热损害。
Endoscopic resection of early colorectal neoplasms typically employs electrocautery tools, which lack precision and run the risk of full thickness thermal injury to the bowel wall with subsequent perforation. We present a means of endoluminal colonic ablation using picosecond laser pulses as a potential alternative to mitigate these limitations. High intensity ultrashort laser pulses enable nonlinear absorption processes, plasma generation, and as a consequence a predominantly non-thermal ablation regimen. Robust process parameters for the laser resection are demonstrated using fresh ex vivo pig intestine samples. Square cavities with comparable thickness to early colorectal neoplasms are removed for a wavelength of 1030 nm and 515 nm using a picosecond laser system. The corresponding histology sections exhibit in both cases only minimal collateral damage to the surrounding tissue. The ablation depth can be controlled precisely by means of the pulse energy. Overall, the application of ultrafast lasers for the resection of intestine enables significantly improved precision and reduced thermal damage to the surrounding tissue compared to conventional electrocautery.