LASER PROBE WITH INTEGRATED CONTACT COOLING FOR SUBSURFACE TISSUE THERMAL REMODELING.
LASER PROBE WITH INTEGRATED CONTACT COOLING FOR SUBSURFACE TISSUE THERMAL REMODELING.
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发表时间：
2018-04
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通讯作者：
Chun-Hung Chang;N. Fried
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作者：
Chun-Hung Chang;N. Fried
在美国，超过650万女性患有女性压力性尿失禁（SUI）。只有约20万女性选择手术。非手术、微创手术可能发挥作用，使盆腔内筋膜中的粘膜下胶原蛋白发生热收缩/重塑。本研究描述了一种新型探头的设计、表征和初步测试，该探头具有集成接触冷却功能，可用于经阴道激光治疗SUI。通过600 μ m芯光纤跳线将1075 nm深穿透近红外波长的激光能量输送到90°侧射探头（19 × 22 mm）中，该探头具有集成流动池和蓝宝石窗口，通过循环醇基溶液冷却至-2 ° C。一个可膨胀的气球连接到探针确保与阴道壁接触。力传感器和热电偶监测压力和温度。在三具尸体的阴道组织中产生热损伤（功率= 4.6-6.4 W;光斑直径= 5.2 mm;时间= 30 s）。测量的热损伤面积为3.1-4.6 mm 2，同时保留阴道壁至0.8-1.1 mm的深度。使用力传感器保持一致的组织接触和冷却。初步的尸体研究表明，在部分保留阴道壁的情况下，对盆腔内筋膜进行了皮下治疗。未来的研究将优化参数的热重塑与进一步的组织表面保护。
Over 6.5 million women in the United States suffer from female stress urinary incontinence (SUI). Only ~200,000 women choose surgery. There may be a role for a non-surgical, minimally invasive procedure that provides thermal shrinkage/remodeling of submucosal collagen in the endopelvic fascia. This study describes design, characterization, and preliminary testing of a novel probe with integrated contact cooling for potential use in transvaginal laser treatment of SUI. Laser energy at a deeply penetrating, near-infrared wavelength of 1075 nm was delivered through a 600-μm-core fiber optic patchcord into a 90° side-firing probe head (19 × 22 mm) with integrated flow cell and sapphire window cooled to -2°C by circulating an alcohol-based solution. An inflatable balloon attached to the probe insured contact with vaginal wall. A force sensor and thermocouples monitored pressure and temperature. Thermal lesions were created in vaginal tissue of three cadavers (power = 4.6-6.4 W; spot diameter = 5.2 mm; time = 30 s). Thermal lesion areas measured 3.1-4.6 mm2, while preserving the vaginal wall to a depth of 0.8-1.1 mm. Consistent tissue contact and cooling was maintained using the force sensors. Preliminary cadaver studies demonstrated subsurface treatment of endopelvic fascia with partial preservation of the vaginal wall. Future studies will optimize parameters for thermal remodeling with further tissue surface preservation.