Indirect laser surgery

Bredikhin, V. I.; Kamensky, Vladislav A.; Sapogova, Natalia; Elagin, Vadim; Shakhova, Maria; Snopova, Ludmila B.; Bityurin, N.

doi:10.1007/s00339-016-9734-2

Cited by 13 publications

(17 citation statements)

References 15 publications

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“…For this purpose, our research team has developed a method for controlled coarse fragmentation of calculi using a strongly heated distal fiber tip (the "hot spot" method) with a light-absorbing coating of colloidal solution of graphite microparticles in silicone varnish [7]. Stone fragmentation effect was achieved through the high temperature of the distal fiber tip [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Diode Laser Lithotripsy of Urinary Calculi Using Controlled Fragmentation Technique

Streltsova¹,

Grebenkin²,

Bredikhin³

et al. 2019

Sovrem Tehnol Med

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One of the triggers of infectious processes developing in the kidney after contact laser lithotripsy is calculus disintegration followed by the release of bacteria and toxins from the biofilm. Prevention urgency determines the search for new mechanisms and methods of laser calculus fragmentation without scattering of fragments and microbial dissemination into the pelvicalyceal system of the kidney. The aim of the study was to evaluate the possibilities of applying the technology of urinary calculus fragmentation with continuouswave diode lasers of different wavelengths using fiber light guides with strongly heated distal tips for controlled fragmentation and minimization of traumatic effects on the adjacent tissues. Materials and Methods. To fragment postoperative samples of porous urinary stones (n=58), we applied standard certified continuouswave diode 10 W lasers with fiber output to quartz light guides, their distal tips being coated with a layer of graphite microparticles in silicone varnish. The quality of stone fragmentation using lasers with wavelengths of 0.81 (n=17), 0.97 (n=22), and 1.47 µm (n=19) and identical quartz light guides were evaluated. Control of laser-induced heating of the urinary tract tissues adjacent to the stone was carried out on the model medium with a thermocouple. Simulation of intraoperative errors (short contact with the ureteral wall as the result of the fiber slipping off the stone surface) was performed on the ureteral wall took post mortem. Tissue condition was assessed using histological sections stained with hematoxylin and eosin. Results. The average fragmentation time depended on calculus density and cross-sectional dimension and was 12-15 s. All selected stones, including those potentially infected, with X-ray density 119 to 1735 HU were fragmented effectively both in liquid and air. Assessment of temperature regimes provided by lasers with 0.81 and 0.97 µm wavelengths showed that the stone surface temperature during fragmentation in the air reached 40 and 57°C, respectively, and it was 25 and 33°C in liquid. The obtained morphological and thermometric data suggest safety of lasers used for controlled fragmentation of potentially infected urinary calculi. Conclusion. The use of continuous-wave diode lasers with strongly heated distal fiber tips at 0.81 and 0.97 µm wavelengths makes it possible to successfully fragment potentially infected urinary stones into size-controlled fragments, which may become a significant factor in prevention of systemic inflammatory response in the postoperative period.

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Section: Introductionmentioning

confidence: 99%

“…The lasers under study differ in tissue penetration depth and, consequently, their thermal effect on the tissue. When using a light guide with a light-absorbing coating, the surrounding tissues absorb laser radiation, which inevitably leads to their topical heating [7].…”

Section: Introductionmentioning

confidence: 99%

Diode Laser Lithotripsy of Urinary Calculi Using Controlled Fragmentation Technique

Streltsova¹,

Grebenkin²,

Bredikhin³

et al. 2019

Sovrem Tehnol Med

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“…The development of new methods of contact laser surgery on a soft tissue requires optimization of the very procedure of tissue incision. Investigation of the specificities of contact cutting with novel coatings changing the temperature distribution at the incision site, 'indirect laser surgery' [11], should be carried out. The coating most commonly used in practice [12,13] is the strongly absorbing coating applied on tip of the fiber, which leads to high absorption of light and strong heating of the silica scalpel.…”

Section: Introductionmentioning

confidence: 99%

Model for indirect laser surgery

Sapogova

Bredikhin

Bityurin

et al. 2016

Biomed. Opt. Express

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Abstract:We present a theoretical model for laser cutting of biological tissue by a strongly heated fiber tip with a highly absorbing coating. A significant dependence of the cutting speed and cutting depth on the inclination angle of the scalpel to the surface when scattering exceeds absorption in the biological tissue is shown. Experimental evidences of this effect are presented. In the experiment, we used silica fiber with coating made of carbon and silicon organic varnish, the 0.97-µm wavelength laser and porcine skin. The additional opportunity to increase the efficiency of cutting by deposition of the absorbing layer on the tissue surface is considered.

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“…In recent years, to enhance the efficiency of cutting biotissues and teeth, there have been suggested various converters for an operating end of a laser fiber in order to change modes of exposure to tissue [7][8][9]. Optic fiber exhibits mechanical flexibility, its quartz core being very strong as it can stand high temperature resulted from contact interaction with a calculus.…”

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confidence: 99%

“…For fragmentation, calculi were put in a saline solution. The contact zone of the light guide with a stone (heated to 2000°K) [8] was smeared with a CО 2 gas stream. The fiber tip resided and moved in the same vertical plane perpendicular to the stone surface.…”

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confidence: 99%