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Evaluations on laser ablation of ex vivo porcine stomach tissue for development of Ho:YAG-assisted endoscopic submucosal dissection (ESD)
- Source :
- Lasers in medical science. 36(7)
- Publication Year :
- 2020
-
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.
- Subjects :
- Target lesion
Materials science
Endoscopic Mucosal Resection
Swine
medicine.medical_treatment
Perforation (oil well)
Dermatology
Lasers, Solid-State
Lesion
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
In vivo
Stomach Neoplasms
medicine
Animals
Laser ablation
business.industry
Stomach
030206 dentistry
Ablation
medicine.anatomical_structure
Surgery
Laser Therapy
medicine.symptom
Nuclear medicine
business
Ex vivo
Subjects
Details
- ISSN :
- 1435604X
- Volume :
- 36
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- Lasers in medical science
- Accession number :
- edsair.doi.dedup.....7938fc8c787a2f2110d51d1385512b02