Comparison of A 1940 nm Thulium-Doped Fiber Laser and A 1470 nm Diode Laser for Cutting Efficacy and Hemostasis in A Pig Model of Spleen Surgery
Bogusława Żywicka , Zbigniew Rybak , Maciej Janeczek , Albert Czerski , Jolanta Bujok , Maria Szymonowicz , Maciej Dobrzyński , Mariusz Korczyński , Jacek Świderski
AbstractPartial and total splenectomies are associated with a high risk of substantial blood loss. Lasers operating at wavelengths strongly absorbed by water have the potential to improve hemostasis and cut while providing a narrow zone of thermal damage. The aim of this study is to compare a thulium-doped fiber laser (TDFL) emitting a wavelength of 1940 nm and a diode laser (DL) operating at 1470 nm for spleen surgery in a pig model. A partial splenectomy and spleen incisions were made in 12 animals using the two laser devices. The hemostasis was evaluated visually during surgeries. Post-mortem and histopathological evaluations were done on days 0, 7, and 14 following surgery. Neither TDFL nor DL caused bleeding on day 0 or delayed bleeding. On day 14, pale streaks at the site of incision were slightly wider after cutting with DL than with TDFL. Histological analysis revealed a carbonized zone with exudation and a deeper zone of thermal tissue damage on day 0. The width of the thermal changes was 655.26 ± 107.70 μm for TDFL and 1413.37 ± 111.85 μm for DL. On day 7, a proliferation of fibroblasts and splenocytes was visible, as well as a formation of multinucleated giant cells adjacent to the residues of carbonization. The zone of thermal damage was broader for DL (1157.5 ± 262.77 μm) than for TDFL (682.22 ± 116.58 μm). On day 14, cutting sites were filled with connective and granulation tissues with the residues of carbonization. The zone of thermal damage was narrower for TDFL (761.65 ± 34.3 μm) than for DL (1609.82 ± 202.22 μm). Thus, both lasers are efficient in spleen surgery, providing good hemostasis. However, TDFL produces a narrower zone of thermal damage, which suggests its better efficiency for spleen surgery, especially when performing more precise procedures.
|Journal series||Materials, ISSN 1996-1944, (N/A 140 pkt)|
|Publication size in sheets||0.6|
|Keywords in English||diode laser (1470 nm); hemostasis; partial splenectomy; pig model of spleen surgery; thermal damage zone; thulium-doped fiber laser (1940 nm)|
|Internal identifier||PX-5e7c8fe2d5de0881737c3007; PX-5e7c92f5d5de0881737c301e|
|Score||= 140.0, 28-05-2020, ArticleFromJournal|
|Publication indicators||= 0; = 0; : 2017 = 1.285; : 2018 = 2.972 (2) - 2018=3.532 (5)|
|Citation count*||5 (2020-07-07)|
* presented citation count is obtained through Internet information analysis and it is close to the number calculated by the Publish or Perish system.