Key result
A 1470-nm diode laser successfully sealed and cut ex vivo porcine renal vessels in 2.0 seconds, achieving mean burst pressures of 1305±783 mmHg and a lateral thermal spread of 0.94±0.48 mm.
Why the study?
Does a high-power 1470-nm diode laser effectively seal and cut ex vivo porcine renal vessels?
Does a high-power 1470-nm diode laser effectively seal and cut ex vivo porcine renal vessels?
A 1470-nm diode laser can rapidly and effectively seal and cut ex vivo porcine renal vessels, providing high burst pressures and minimal thermal spread.
Supports preclinical development of 1470-nm diode lasers for vessel sealing; leaves open translation to in vivo or clinical use.
Suture ligation with subsequent cutting of blood vessels to maintain hemostasis during surgery is time consuming and skill intensive. Energy-based electrosurgical and ultrasonic devices are often used to replace sutures and mechanical clips to provide rapid hemostasis and decrease surgery time. Some of these devices may create undesirably large collateral zones of thermal damage and tissue necrosis, or require separate mechanical blades for cutting. Infrared lasers are currently being explored as alternative energy sources for vessel sealing applications. In a previous study, a 1470-nm laser was used to seal vessels 1 to 6 mm in diameter in 5 s, yielding burst pressures of ∼500 mmHg. The purpose of this study was to provide vessel sealing times comparable with current energy-based devices, incorporate transection of sealed vessels, and demonstrate high vessel burst pressures to provide a safety margin for future clinical use. A 110-W, 1470-nm laser beam was transmitted through a fiber and beam shaping optics, producing a 90-W linear beam 3.0 by 9.5 mm for sealing (400 W/cm2), and 1.1 by 9.6 mm for cutting (1080 W/cm2). A two-step process sealed and then transected ex vivo porcine renal vessels (1.5 to 8.5 mm diameter) in a bench top setup. Seal and cut times were 1.0 s each. A burst pressure system measured seal strength, and histologic measurements of lateral thermal spread were also recorded. All blood vessels tested (n=55 seal samples) were sealed and cut, with total irradiation times of 2.0 s and mean burst pressures of 1305±783 mmHg. Additional unburst vessels were processed for histological analysis, showing a lateral thermal spread of 0.94±0.48 mm (n=14 seal samples). This study demonstrated that an optical-based system is capable of precisely sealing and cutting a wide range of porcine renal vessel sizes and, with further development, may provide an alternative to radiofrequency- and ultrasonic-based vessel sealing devices.
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Giglio et al. (2014) studied Ex vivo porcine renal vessels (n=55). 1470-nm diode laser was evaluated on Vessel sealing and cutting success, burst pressure, and lateral thermal spread. A 1470-nm diode laser successfully sealed and cut ex vivo porcine renal vessels in 2.0 seconds, achieving mean burst pressures of 1305±783 mmHg and a lateral thermal spread of 0.94±0.48 mm.
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