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Quantitative evaluation of the safety of mucosal incision and submucosal dissection for colon during endoscopic submucosal dissection using carbon dioxide laser
Author(s): Takuma Noguchi; Norihiro Honda; Hisanao Hazama; Yoshinori Morita; Kunio Awazu
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Paper Abstract

Since the increase in the overall mortality rate in patients with colon cancer is remarkably high in recent years, early treatment is required. For this reason, endoscopic submucosal dissection (ESD) has been at the forefront of international attention as a low invasive treatment for early digestive cancer. In current ESD procedure, an electrosurgical knife is used for mucosal incision and subsequent submucosal dissection. However, the perforation has been reported to occur by approximately 5%. Thus, to enhance the tissue selectivity of this modality, we focused on the application of laser for ESD. A carbon dioxide laser was chosen as a surgical knife because the saline or a sodium hyaluronate solution injected into the submucosal layer in current ESD procedure has a high absorption coefficient at the wavelength of the carbon dioxide laser. In this research, ex vivo experiment was performed at the output power of 3–7 W and discuss the optimum irradiation power of laser. As a result of ex vivo experiment using extracted porcine colon tissues, mucosal incision and submucosal dissection were safely and less invasively performed in every output power, without reaching the thermal damage to a muscular layer. This is because a carbon dioxide laser is strongly absorbed by saline injected into submucosa. ESD using a carbon dioxide laser is a safer method for the treatment of early colon cancer. We are planning to measure and compare the optical and thermal properties of porcine colon with those of human colon.

Paper Details

Date Published: 13 February 2018
PDF: 7 pages
Proc. SPIE 10492, Optical Interactions with Tissue and Cells XXIX, 104920D (13 February 2018); doi: 10.1117/12.2285537
Show Author Affiliations
Takuma Noguchi, Osaka Univ. (Japan)
Norihiro Honda, Osaka Univ. (Japan)
Hisanao Hazama, Osaka Univ. (Japan)
Yoshinori Morita, Kobe Univ. School of Medicine (Japan)
Kunio Awazu, Osaka Univ. (Japan)


Published in SPIE Proceedings Vol. 10492:
Optical Interactions with Tissue and Cells XXIX
E. Duco Jansen; Hope Thomas Beier, Editor(s)

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