Abstract:Abstract. 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 alt… Show more
“…Given this, it is paramount to have an objective method with which vessel seals can be evaluated so that the hemostatic capabilities of laser-based systems can be tested. Current methodologies used for this purpose include burst pressure analysis (BPA), [9][10][11] microscopy, 12 and visual examination. [13][14][15][16] While BPA yields valuable insight as to the strength of seals, it cannot be performed in situ without invasive measures.…”
Doppler optical coherence tomography for energy seal evaluation and comparison to visual evaluation," J.Abstract. Laser energy sealing systems have attracted much attention over the past decade Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.
“…Given this, it is paramount to have an objective method with which vessel seals can be evaluated so that the hemostatic capabilities of laser-based systems can be tested. Current methodologies used for this purpose include burst pressure analysis (BPA), [9][10][11] microscopy, 12 and visual examination. [13][14][15][16] While BPA yields valuable insight as to the strength of seals, it cannot be performed in situ without invasive measures.…”
Doppler optical coherence tomography for energy seal evaluation and comparison to visual evaluation," J.Abstract. Laser energy sealing systems have attracted much attention over the past decade Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.
“…The 1,470 nm wavelength was found to seal porcine vessels of 1–6 mm diameter in less than 5 seconds. A subsequent study demonstrated faster sealing, transection of sealed tissue, increased burst strength, and greater safety margin . The laser sealed and cut ex vivo porcine renal arteries of 1–8 mm diameter in 2 seconds, yielding burst pressures greater than 1,200 mmHg and thermal coagulation zones less than 3 mm.…”
“…Our laboratory is currently exploring infrared (IR) lasers as an alternative energy modality for vessel sealing, capable of generating less collateral thermal damage. 21,22 Previous studies demonstrated the feasibility of sealing vessels in an open in vivo porcine model using a 1470-nm diode laser. 23 However, the initial prototype was designed for testing in open surgery and featured a plunger style tissue clasping mechanism and 12.7-mm outer-diameter optical components in the light delivery mechanism that were incompatible with standard laparoscopic surgical instruments and size constraints.…”
Section: Infrared Laser Vessel Sealingmentioning
confidence: 99%
“…Fresh porcine kidney pairs were obtained from a slaughterhouse (Spear Products, Inc., Coopersburg, Pennsylvania) and renal arteries were then dissected, cleaned of fat, and kept hydrated with saline for use within 24 h. The entire vascular tree for each kidney was carefully dissected and surgically exposed in a similar manner to previous studies, 21,22 providing multiple vessels with a wide range of diameters for testing. A total of 69 vessels were tested, ranging from 1.0 to 6.6 mm in diameter and with a mean diameter of 3.3 AE 1.7 mm.…”
Energy-based, radiofrequency (RF) and ultrasonic (US) devices currently provide rapid sealing of blood vessels during laparoscopic procedures. We are exploring infrared lasers as an alternate energy modality for vessel sealing, capable of generating less collateral thermal damage. Previous studies demonstrated feasibility of sealing vessels in an in vivo porcine model using a 1470-nm laser. However, the initial prototype was designed for testing in open surgery and featured tissue clasping and light delivery mechanisms incompatible with laparoscopic surgery. In this study, a laparoscopic prototype similar to devices currently in surgical use was developed, and performance tests were conducted on porcine renal blood vessels, ex vivo. The 5-mm outer-diameter laparoscopic prototype featured a traditional Maryland jaw configuration that enables tissue manipulation and blunt dissection. Laser energy was delivered through a 550 - ? m -core-diameter optical fiber with side-delivery from the lower jaw and beam dimensions of 18 - mm ? length × 1.2 - mm ? width . The 1470-nm diode laser delivered 68 W with 3-s activation time, consistent with vessel seal times associated with RF and US-based devices. A total of 69 fresh porcine renal vessels with mean diameter of 3.3 ± 1.7 ?? mm were tested, ex vivo. Vessels smaller than 5-mm diameter were consistently sealed (48/51) with burst pressures greater than malignant hypertension blood pressure (180 mmHg), averaging 1038 ± 474 ?? mmHg . Vessels larger than 5 mm were not consistently sealed (6/18), yielding burst pressures of only 174 ± 221 ?? mmHg . Seal width, thermal damage zone, and thermal spread averaged 1.7 ± 0.8 , 3.4 ± 0.7 , and 1.0 ±
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