In vivo study of partial liver resection on pigs using a 1.9 μm thulium fiber laser

Theisen-Kunde, Dirk; Wolken, H.; Danicke, Veit; Brinkmann, Ralf; Bruch, H. P.; Kleemann, Markus

doi:10.1117/12.889423

Cited by 2 publications

(4 citation statements)

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“…In our experiment no visible blood loss or very minor bleeding was observed after resection of distal 2/3 of right lateral lobe in swine. Similar results were observed by Theisen-Knude et al [ 25 ] in porcine model of partial liver resection with a 1.9 μ m thulium laser. An atypical partial hepatectomy by open and laparoscopic techniques did not result in significant bleeding or bile leakage, suggesting feasibility of the Tm:fiber laser in liver surgery [ 25 , 26 ].…”

Section: Discussionsupporting

confidence: 90%

“…Similar results were observed by Theisen-Knude et al [ 25 ] in porcine model of partial liver resection with a 1.9 μ m thulium laser. An atypical partial hepatectomy by open and laparoscopic techniques did not result in significant bleeding or bile leakage, suggesting feasibility of the Tm:fiber laser in liver surgery [ 25 , 26 ]. Moreover, in experimental partial nephrectomy using Tm:fiber laser, good hemostasis was observed [ 24 ].…”

Section: Discussionsupporting

confidence: 90%

“…Similar width of the thermal damage zone (less than 2.0 mm) was reported in an experimental pig model of partial nephrectomy with Tm:fiber laser. In another pig model of atypical liver resection with Tm:fiber laser emitting a wavelength of ~ 1.9 μ m in a contact mode a narrow scar width of approximately 1-2 mm after 14-16 days was also noted [ 24 , 25 ]. However, in a pig model of laparoscopic liver resection 11-15 days after surgery the total thermal damage zone exceeded 5 mm [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

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Preliminary Evaluation of Thulium Doped Fiber Laser in Pig Model of Liver Surgery

Janeczek

Świderski

Czerski

et al. 2018

BioMed Research International

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Partial liver resection is a treatment of choice for liver tumors; the range of parenchyma excision varies from a small part of the tissue surrounding the neoplasm up to 70% of the organ. One of the major concerns during liver resection is blood loss. Thulium lasers which are characterized by the length of emission wave corresponding to a peak absorption of water create a new possibility of cutting tissues efficiently with minimal thermal damage and concurrently providing a good hemostasis control. The aim of our study was to evaluate an impact of liver transection with thulium doped fiber laser on an intraoperative bleeding and histopathological changes during postoperative period in swine model. Ten animals were subjected to open surgery partial liver resection and an incision of liver tissue with an all-fiber, diode-pumped, and continuous-wave Tm3+-doped fiber laser emitting 37.4 W of output power at ~1.94 μm wavelength. The macroscopic and histopathological evaluation was performed intraoperatively as well as 7 and 14 days after surgery. Macroscopically almost no bleeding was observed during surgery and no signs of bleeding were stated after 7 and 14 days. Histopathological analysis of the transection margin revealed a thermal damage area ranging in depth from 620.23 ± 23.82 μm on the day of surgery to 1817.70 ± 211.98 μm after 7 days. In the samples taken intraoperatively and after 7 days a superficial zone of carbonization was visibly separated from the deeper changes. After 14 days one 765.35 μm deep zone characterized by a granulation was present. In conclusion, thulium doped fiber laser is efficacious in cutting with a narrow zone of thermal injury and provides a good hemostasis during liver transection, thus being a potential tool for oncotic liver surgery.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Preliminary Evaluation of Thulium Doped Fiber Laser in Pig Model of Liver Surgery

Janeczek

Świderski

Czerski

et al. 2018

BioMed Research International

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“…Maciej et al states that TDFL had a very good cutting properties while the total depth of thermal changes in the liver tissue ranges from 0.62 to 1.82 mm depending on the time of evaluation. Similar width of the thermal damage zone (less than 2.0 mm) was reported in an experimental pig model for partial nephrectomy with TDFL [ 12 , 19 , 20 ]. TDFL also has potent local thermal effect resulting in its ability to cut and coagulate, thus providing hemostasis.…”

Section: Discussionsupporting

confidence: 77%

The use of Thulium-Doped Fiber Laser (TDFL) 1940 nm as an energy device in liver parenchyma resection, a-pilot-study in Indonesia

Tendean

Mambu

Tjandra

et al. 2020

Annals of Medicine and Surgery

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Introduction Several modalities are used to improve the outcome of liver resection surgery. Laser-based surgery may become promising option; therefore we aim to report our experience regarding the efficacy and safety of Thulium-Doped Fiber Laser (TDFL) 1940 nm in liver parenchyma resection. Methods A cross sectional study in which patients with pre-existing liver pathology during July 2019 and July 2020 were randomly assigned to receive liver resection using TDFL integrated with raman laser emitting at 1940 nm and 1470 nm wavelength. Data on estimated blood loss during liver transection, liver transection speed, morbidity rate, and postoperative variables including complications, length of hospital stay (days), and mortality were analyzed. Results A total of 17 consecutive liver resections were performed, among them are 7 major and 11 minor hepatectomies. The Multipulse TM+1470 were used on 8 procedures consisted of 1 major and 7 minor hepatectomies, the mean amount of blood loss during operation and liver transection was 628.13 ± 141.31 mL and 294.63 ± 94.81 ml, respectively. The mean liver transection speed was 1.52 ± 0.27 cm 2 /min. No biliary leak, post-hepatectomy-liver failure, and mortality were reported. Conclusion TDFL provided by Multipulse TM+1470 is an effective and safe tool for liver surgery, providing good hemostasis and allowing for safe and effective exposure of vascular. Further study with larger samples might be needed proved the efficacy and safety of TDFL in liver surgery.

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In vivo study of partial liver resection on pigs using a 1.9 μm thulium fiber laser

Cited by 2 publications

References 0 publications

Preliminary Evaluation of Thulium Doped Fiber Laser in Pig Model of Liver Surgery

Preliminary Evaluation of Thulium Doped Fiber Laser in Pig Model of Liver Surgery

The use of Thulium-Doped Fiber Laser (TDFL) 1940 nm as an energy device in liver parenchyma resection, a-pilot-study in Indonesia

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