Efficient bone cutting with the novel diode pumped Er:YAG laser system: in vitro investigation and optimization of the treatment parameters

It is well known that flashlamp pumped Er:YAG lasers allow efficient bone ablation due to strong absorption at 3μm by water. Preliminary experiments revealed also a newly developed diode pumped Er:YAG laser system (Pantec Engineering AG) to be an efficient tool for use for bone surgery. The aim of the present in vitro study is the investigation of a new power increased version of the laser system with higher pulse energy and optimization of the treatment set-up to get high cutting quality, efficiency, and ablation depth. Optical simulations were performed to achieve various focus diameters and homogeneous beam profile. An appropriate experimental set-up with two different focusing units, a computer controlled linear stage with sample holder, and a shutter unit was realized. By this we are able to move the sample (slices of pig bone) with a defined velocity during the irradiation. Cutting was performed under appropriate water spray by moving the sample back and forth. After each path the ablation depth was measured and the focal plane was tracked to the actual bottom of the groove. Finally, the cuts were analyzed by light microcopy regarding the ablation quality and geometry, and thermal effects. In summary, the results show that with carefully adapted irradiation parameters narrow and deep cuts (ablation depth > 6mm, aspect ratio approx. 20) are possible without carbonization. In conclusion, these in vitro investigations demonstrate that high efficient bone cutting is possible with the diode pumped Er:YAG laser system using appropriate treatment set-up and parameters.