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Investigation on the Smoke Development during Laparoscopic Surgery

机译：腹腔镜手术过程中烟气生成的调查

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摘要

Objective: During laser assisted laparoscopic intervention smoke occurs reducing the clear vision to the target. Simply smoke suction is not possible with respect to deflating / enflating capabilities of the belly. Thus the clinical question arise if the use of different wavelength may show similar smoke development or whether is it possible to reduce the smoke development by wavelength selection. Materials and Methods: Tissue test model was "Bavarian Leberkaese". A special container set-up was created to collect the laser induced smoke. Smoke was suctioned through a capillary. The amount of light scattered by the smoke particles when flowing through this capillary was measured. Ablation parameter was continuous mode and 10W at the end of a 400μm bare fibre for the wavelengths 980nm, 1350nm and 1470nm. Additional the optical transmission was measured. The vaporized tissue volume was measured. Results: Light scattering, optical parameters and vaporized tissue volume were correlated. Measurement showed reproducible results. While the time to get first signal of scattered light in case of 1470nm is shorter compared the other wavelength, the ratio of scatter-signal to ablation rate showed only a trend increase when longer wavelength were used. Conclusion: Tissue absorbers and carbonized tissue properties are relevant for smoke development resulting in an increased SI / AR ratio trend. Thus the expert physician in laparoscopic intervention should also be an expert in laser-tissue interaction. Cutting without carbonization gained advantages.
机译：目的：在激光辅助的腹腔镜介入治疗过程中，烟雾会降低目标的清晰视力。就腹部的放气/扩张能力而言，单纯地抽吸烟是不可能的。因此，如果使用不同的波长可能显示出类似的烟雾发展，或者是否有可能通过选择波长来减少烟雾的发展，就会出现临床问题。材料和方法：组织测试模型为“巴伐利亚Leberkaese”。创建了一个特殊的容器设置来收集激光诱导的烟雾。通过毛细管抽吸烟雾。测量了流经该毛细管时烟尘颗粒散射的光量。烧蚀参数为连续模式，在波长为980nm，1350nm和1470nm的400μm裸光纤末端处为10W。另外测量了光透射率。测量汽化的组织体积。结果：光散射，光学参数和汽化组织体积相关。测量显示可重复的结果。虽然在1470nm的情况下获得散射光的第一信号的时间比其他波长要短，但是当使用更长的波长时，散射信号与烧蚀率的比率仅显示出增加的趋势。结论：组织吸收剂和碳化的组织特性与烟雾的产生有关，从而导致SI / AR比趋势增加。因此，腹腔镜干预的专家医师也应该是激光组织相互作用的专家。没有碳化的切割获得了优势。

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  • 来源
    《Photonic therapeutics and diagnostics X》|2014年|89261D.1-89261D.4|共4页
  • 会议地点 San Francisco CA(US)
  • 作者

    Ronald Sroka; Sebastian Fiedler; Thomas Pongratz; Wolfgang Beyer; Georg Hennig; Adrian Ruehm; Wael Khoder;

  • 作者单位

    Laser-Forschungslabor, LIFE-Zentrum, Klinikum der Universitaet Muenchen, Marchioninistr. 23, 81377 Muenchen, Germany;

    Laser-Forschungslabor, LIFE-Zentrum, Klinikum der Universitaet Muenchen, Marchioninistr. 23, 81377 Muenchen, Germany;

    Laser-Forschungslabor, LIFE-Zentrum, Klinikum der Universitaet Muenchen, Marchioninistr. 23, 81377 Muenchen, Germany;

    Laser-Forschungslabor, LIFE-Zentrum, Klinikum der Universitaet Muenchen, Marchioninistr. 23, 81377 Muenchen, Germany;

    Laser-Forschungslabor, LIFE-Zentrum, Klinikum der Universitaet Muenchen, Marchioninistr. 23, 81377 Muenchen, Germany;

    Laser-Forschungslabor, LIFE-Zentrum, Klinikum der Universitaet Muenchen, Marchioninistr. 23, 81377 Muenchen, Germany;

    Dept. of Urology, Klinikum der Universitaet Muenchen, Marchioninistr. 15, 81377 Muenchen, Germany;

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  • 原文格式 PDF
  • 正文语种 eng
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  • 关键词

    urology; laser surgery; smoke; laparoscopy;

    机译：泌尿科激光手术；抽烟;腹腔镜;

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