Investigation of the efficacy of ultrafast laser in large bowel excision

Syam Mohan P. C. Mohanan, Rainer J. Beck, Wojciech Stanisław Góra, Sarah L. Perry, Mike Shires, David Jayne, Duncan Paul Hand, Jonathan D. Shephard

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Local resection of early stage tumors in the large bowel via colonoscopy has been a widely accepted surgical modality for colon neoplasm treatment. The conventional electrocautery techniques used for the resection of neoplasia in the mucosal or submucosal layer of colon tissue has been shown to create obvious thermal necrosis to adjacent healthy tissues and lacks accuracy in resection. Ultrafast picosecond (ps) laser ablation using a wavelength of 1030 or 515 nm is a promising surgical tool to overcome the limitations seen with conventional surgical techniques. The purpose of this initial study is to analyze the depth of ablation or the extent of coagulation deployed by the laser as a function of pulse energy and fluence in an ex-vivo porcine model. Precise control of the depth of tissue removal is of paramount importance for bowel surgery where bowel perforation can lead to morbidity or mortality. Thus we investigate the regimes that are optimal for tissue resection and coagulation through plasma mediated ablation of healthy colon tissue. The ablated tissue samples were analyzed by standard histologic methods and a three dimensional optical profilometer technique. We demonstrate that ultrafast laser resection of colonic tissue can minimize the region of collateral thermal damage (<50 μm) with a controlled ablation depth. This surgical modality allows potentially easier removal of early stage lesions and has the capability to provide more control to the surgeon in comparison with a mechanical or electrocautery device.

Original languageEnglish
Title of host publicationOptical Interactions with Tissue and Cells XXVIII
PublisherSPIE
ISBN (Electronic)9781510605664
ISBN (Print)9781510605657
DOIs
Publication statusPublished - 15 Feb 2017
EventOptical Interactions with Tissue and Cells XXVIII - San Francisco, United States
Duration: 30 Jan 201731 Jan 2017

Publication series

NameProceedings of SPIE
PublisherSPIE
Volume10062
ISSN (Print)1605-7422
ISSN (Electronic)2410-9045

Conference

ConferenceOptical Interactions with Tissue and Cells XXVIII
CountryUnited States
CitySan Francisco
Period30/01/1731/01/17

Keywords

  • Cancer
  • Colon
  • Picosecond laser ablation
  • Plasma mediated ablation
  • Thermal necrosis
  • Tissue
  • Ultrafast laser

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Atomic and Molecular Physics, and Optics
  • Biomaterials
  • Radiology Nuclear Medicine and imaging

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  • Cite this

    Mohanan, S. M. P. C., Beck, R. J., Góra, W. S., Perry, S. L., Shires, M., Jayne, D., Hand, D. P., & Shephard, J. D. (2017). Investigation of the efficacy of ultrafast laser in large bowel excision. In Optical Interactions with Tissue and Cells XXVIII [1006207] (Proceedings of SPIE; Vol. 10062). SPIE. https://doi.org/10.1117/12.2251956