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Evaluations on laser ablation of ex vivo porcine stomach tissue for development of Ho:YAG-assisted endoscopic submucosal dissection (ESD).

Authors :
Pyo H
Kim H
Kang HW
Source :
Lasers in medical science [Lasers Med Sci] 2021 Sep; Vol. 36 (7), pp. 1437-1444. Date of Electronic Publication: 2020 Nov 06.
Publication Year :
2021

Abstract

Endoscopic submucosal dissection (ESD) is clinically used to remove early gastric cancer in stomach. The aim of the current study is to examine a therapeutic capacity of pulsed Ho:YAG laser for the development of laser-assisted ESD under various surgical parameters. Ex vivo porcine stomach tissue was ablated with 1-J Ho:YAG pulses at 10 Hz at different number of treatments (NT = 1, 2, and 3) and treatment speeds (TS = 0.5, 1, and 2 mm/s) without and with saline injection. Regardless of saline injection, straight tissue ablation showed that ablation depth increased with increasing NT and decreasing TS. At NT = 3 and TS = 0.5 mm/s, no saline injection yielded the maximum ablation depth (3.4 ± 0.3 mm), partially removing muscularis propria. However, saline injection confined the tissue ablation within a submucosal layer (2.1 ± 0.3 mm). Thermal injury was found to be 0.7~1.1 mm in the adjacent tissue with superficial carbonization. Circular tissue ablation (2 cm in diameter) at NT = 3 and TS = 0.5 mm/s presented that no saline injection yielded a reduction in the lesion area, whereas saline injection maintained the ablated lesion area. Histological analysis revealed that unlike no saline injection, saline injection ablated the entire mucosal layer without perforation in the muscular propria. The pulsed Ho:YAG laser can be a potential surgical tool for clinical ESD to incise a target lesion without adverse perforation. Further investigations will validate the efficacy and safety of the Ho:YAG laser-assisted ESD in in vivo porcine stomach models for clinical translation.<br /> (© 2020. Springer-Verlag London Ltd., part of Springer Nature.)

Details

Language :
English
ISSN :
1435-604X
Volume :
36
Issue :
7
Database :
MEDLINE
Journal :
Lasers in medical science
Publication Type :
Academic Journal
Accession number :
33156475
Full Text :
https://doi.org/10.1007/s10103-020-03182-0