Application of a 980-nanometer diode laser in neuroendoscopy: a case series

Abstract

V entricular neuroendoscopy represents an important advance in the treatment of hydrocephalus. About 30% of patients with hydrocephalus meet the criteria for this technique, which may prevent the need for a ventriculoperitoneal shunt, resulting in reduced costs and low incidence of late complications. 4,5,6,7,12,15,17 Nonetheless, because a ventricular endoscope is used through a single bur hole, additional resources to enable cutting, coagulation, and ablation of injuries are extremely relevant to reduce surgical time and hospital length of stay, and increase the safety of the procedure and the patient's postoperative comfort. 8,10,18 Increasing experience in several centers has proven that laser-assisted endoscopic procedures are useful options, because they are safe, effective, and advantageous in cases of distorted anatomy. 4,18 We have previously shown favorable results of surgical Nd:YAG and therapeutic laser (diode 685 nm) in neuroendoscopic procedures, such as excision of colloid cysts and myelomeningocele repair. 10,11 Furthermore, the use of 980-nm diode laser in brain tissue of Wistar rats has been tested in recent studies and was associated with a remarkable ablating capacity, minimal thermal damage to surrounding tissue, and lower recovery time than other lasers with different wavelengths or electrocoagulators. The 980-nm-wavelength diode laser provides proper absorption in both water and hemoglobin, which is an adabbreviatioNs μ A (H 2 O) = absorption coefficient of water; CW = continuous wave; ETV = endoscopic third ventriculostomy. obJective Ventricular neuroendoscopy represents an important advance in the treatment of hydrocephalus. Highpower (surgical) Nd:YAG laser and low-level laser therapy (using 685-nm-wavelength diode laser) have been used in conjunction with neuroendoscopy with favorable results. This study evaluated the use of surgical 980-nm-wavelength diode laser for the neuroendoscopic treatment of ventricular diseases. methods Nine patients underwent a neuroendoscopic procedure with 980-nm diode laser. Complications and followup were recorded. results Three in-hospital postoperative complications were recorded (1 intraventricular hemorrhage and 2 meningitis cases). The remaining 6 patients had symptom improvement after endoscopic surgery and were discharged from the hospital within 24-48 hours after surgery. Patients were followed for an average of 14 months: 1 patient developed meningitis and another died suddenly at home. The other patients did well and were asymptomatic until the last follow-up consultation. coNclusioNs The 980-nm diode laser is considered an important therapeutic tool for endoscopic neurological surgeries. This study showed its application in different ventricular diseases.

Specialised Surgical Instruments for Endoscopic and Endoscope-Assisted Neurosurgery: A Systematic Review of Safety, Efficacy and Usability

“…However, it is unclear if this complication, ventriculitis, is directly related to the instrument or the operation given that ventriculitis is a known complication [ 73 ]. The only other instruments to report a postoperative complication rate over 10% were the 6.3 mm Percutaneous Endoscopic Instrument [ 13 ] utilised to treat migrated disk herniation in 22 adult patients, the 980 nm Diode Laser [ 14 ] utilised in nine adult patients with hydrocephalus, the OmniGuide CO2 laser [ 55 ] utilised in a case series of 16 adult patients with pituitary lesions that underwent surgery using the endoscopic endonasal transsphenoidal approach and the SONOCA Ultrasonic Aspirator [ 63 ] utilised in nine adult patients with supratentorial intraventricular tumours that underwent endoscopic resection.…”

Thulium laser‐assisted endoscopic third ventriculostomy: Determining safe laser settings using in vitro model and 2 year follow‐up results in 106 patients

“…Different kinds of wavelengths have been proposed and used for laser‐assisted endoscopic ventriculostomy (LA‐ETV) . Earlier studies show that an 810 nm laser can be safely used in combination with a carbon layer on the tip of the laser fiber that absorbs all the laser light with pulse lengths of 1.0 second at 1–2.0W.…”