Abstract
Background and Objective: Neurosurgery has long required a method for dissecting brain tissue without damaging
principal vessels and adjacent tissue, so as to prevent neurological complications
after operation. In this study we fabricated such a prototype device and used it in
an attempt to resect an animal liver, which, like the brain, contains many vessels.
Materials and Methods: The prototype device consisted of a jet nozzle and a suction tube. Pulsed liquid
jets at 3 Hz were ejected from the nozzle by a pulsed holmium:YAG (Ho:YAG) laser at
an irradiation energy of 230 mJ/pulse. The profile of the liquid jet was observed
with a high-speed camera. With this device, liver dissections of anesthetized rabbits
were attempted while measuring the local temperature of the target. A histological
study of the incised parts was also performed.
Results: The liquid jet was emitted straight from the nozzle at an initial velocity of 38
m/sec. The liver parenchyma was cut with the device while preserving the tiny vessels
and keeping the operative field clear. The local temperature rose to no more than
314 K (below the heat damage threshold of brain tissue). In the histological findings,
there were no signs of hepatic degeneration or necrosis around the dissected margin.
Conclusions: The Ho:YAG laser-induced liquid jet dissector can be applied to neurosurgical operations
after incorporating some minor improvements.
Key words
Holmium:YAG laser - laser-induced liquid jet - minimally invasive surgery - tissue
cutting
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Takayuki Hirano, M. D.
Department of Neurosurgery · Tohoku University Graduate School of Medicine
1-1, Seiryou-machi, Aoba-ku, Sendai 980-8574 · Japan
Phone: +81-22-717-7230
Fax: +81-22-717-7233
Email: taka1789@aol.com