Histologic Evaluation of Blood Vessels Sealed with 1,470-nm Diode Laser: Determination of Adequate Condition for Laser Vessel Sealing
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Introduction Energy-based devices allow for a more rapid and efficient ligation of blood vessels during operations. In the present study, we evaluated the feasibility of a laser as an alternative energy source for the vessel sealing system and determined the optimal condition of laser for an effective vessel sealing through histologic examination. Materials and Methods The arteries (5 mm diameter) harvested from porcine legs were compressed between two glass-slides to eliminate its luminal space and were irradiated with 1,470-nm diode laser under various sealing conditions, including laser power (5-30 W), irradiation time (5 or 10 seconds), and focus mode (focus or defocus). Subsequently, the irradiated vessels were fixed in 4% formaldehyde and then processed to paraffin block. The paraffinized sample was sectioned and stained with hematoxylin and eosin for histological evaluation. Results The extent of tissue change was positively correlated with duration and power of laser. In defocus mode, the irradiated vessels showed sufficient tissue denaturation for sealing effect without severe tissue destruction. Moreover, among the various conditions of irradiation, laser power between 15 and 20 W, as well as exposure time of 5 seconds were appropriate for sealing the blood vessels. Conclusion Adequate power and irradiation duration of laser can render blood vessels to be sealed effectively, although the higher power of laser may be required to cut the vessels.
Abstract
Introduction Energy-based devices allow for a more rapid and efficient ligation of blood vessels during operations. In the present study, we evaluated the feasibility of a laser as an alternative energy source for the vessel sealing system and determined the optimal condition of laser for an effective vessel sealing through histologic examination. Materials and Methods The arteries (5 mm diameter) harvested from porcine legs were compressed between two glass-slides to eliminate its luminal space and were irradiated with 1,470-nm diode laser under various sealing conditions, including laser power (5-30 W), irradiation time (5 or 10 seconds), and focus mode (focus or defocus). Subsequently, the irradiated vessels were fixed in 4% formaldehyde and then processed to paraffin block. The paraffinized sample was sectioned and stained with hematoxylin and eosin for histological evaluation. Results The extent of tissue change was positively correlated with duration and power of laser. In defocus mode, the irradiated vessels showed sufficient tissue denaturation for sealing effect without severe tissue destruction. Moreover, among the various conditions of irradiation, laser power between 15 and 20 W, as well as exposure time of 5 seconds were appropriate for sealing the blood vessels. Conclusion Adequate power and irradiation duration of laser can render blood vessels to be sealed effectively, although the higher power of laser may be required to cut the vessels.
참고문헌 (13)
- Kennedy JS, "Highburst-strength, feedback-controlled bipolar vessel sealing", Surg Endosc, 12, pp.876~878 (1998)
- Payne JH Jr, "Ultrasonic dissection", Surg Endosc, 8, pp.416~418 (1994)
- Person B, "Comparison of four energy-based vascular sealing and cutting instruments: a porcine model", Surg Endosc, 22, pp.534~538 (2008)
- Levy B, "Randomized trial of suture versus electrosurgical bipolar vessel sealing in vaginal hysterectomy", Obstet Gynecol, 102, pp.147~151 (2003)
- Marcello PW, "Vascular pedicle ligation techniques during laparoscopic colectomy. A prospective randomized trial", Surg Endosc, 20, pp.263~269 (2006)
- Romano F, "Laparoscopic splenectomy: ligasure versus EndoGIA: a comparative study", J Laparoendosc Adv Surg Tech A, 17, pp.763~767 (2007)
- Kim FJ, "Temperature safety profile of laparoscopic devices: Harmonic ACE (ACE), Ligasure V (LV), and plasma trisector (PT)", Surg Endosc, 22, pp.1464~1469 (2008)
- Phillips CK, "Tissue response to surgical energy devices", Urology, 71, pp.744~748 (2008)
- Govekar HR, "Residual heat of laparoscopic energy devices: how long must the surgeon wait to touch additional tissue", Surg Endosc, 25, pp.3499~3502 (2011)
- Cilip CM, "Infrared laser thermal fusion of blood vessels: preliminary ex vivo tissue studies", J Biomed Opt, 18, pp.58001~ (2013)
- Giglio NC, "Rapid sealing and cutting of porcine blood vessels, ex vivo, using a high-power, 1470-nm diode laser", J Biomed Opt, 19, pp.38002~ (2014)
- Hope WW, "An evaluation of electrosurgical vesselsealing devices in biliary tract surgery in a porcine model", HPB (Oxford), 12, pp.703~708 (2010)
- Newcomb WL, "Comparison of blood vessel sealing among new electrosurgical and ultrasonic devices", Surg Endosc, 23, pp.90~96 (2009)
