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Journal of Biomedical Optics

Fundamental studies of fiber-guided soft tissue cutting by means of pulsed mid-infrared lasers and its application in ureterotomy
Author(s): Ralf Brinkmann; Ansgar Knipper; Gerit Droege; Frank Schroer; Bernd Gromoll; Reginald Birngruber
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Paper Abstract

Fiber-guided ablation of soft tissue with pulsed holmium and thulium lasers was investigated for intraluminal incisions. A bare fiber/tissue-contact application system with a nearly tangential irradiation geometry was first used in vitro on porcine ureter tissue. The efficiency and precision of the method was analyzed for different laser and application parameters. The ablation dynamics in water and tissue was investigated by fast flash photography. Uniform cuts could be achieved with 200- and 318-µm fibers using a free-running holmium laser with a pulse repetition rate of 10 Hz and an average power of up to 4 W. The depth of the cuts could be increased by using a thulium laser with the same laser parameters. By reducing the pulse duration by one order of magnitude, the quality of the incisions was made more irregular, the zone of thermomechanical damage increased, and the cuts became deeper owing to the growing influence of cavitation on shorter laser pulse durations. In a first clinical trial, 20 patients underwent holmium laser therapy to reopen ureteral strictures. Neither bleeding nor other adverse effects due to the laser treatment occurred, showing IR laser ureterotomy to be a suitable and promising minimally invasive technique.

Paper Details

Date Published: 1 January 1998
PDF: 11 pages
J. Biomed. Opt. 3(1) doi: 10.1117/1.429865
Published in: Journal of Biomedical Optics Volume 3, Issue 1
Show Author Affiliations
Ralf Brinkmann, Medizinisches Laserzentrum Luebeck GmbH (Germany)
Ansgar Knipper, Medizinische Univ. zu Luebeck (Germany)
Gerit Droege, Medizinisches Laserzentrum Luebeck GmbH (Germany)
Frank Schroer, Medical Laser Ctr Luebeck GmbH (Germany)
Bernd Gromoll, Medical Univ. Luebeck (Germany)
Reginald Birngruber, Medizinisches Laserzentrum Luebeck (Germany)

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