Investigation on the smoke development during Laparoscopic surgery

Ronald Sroka; Sebastian Fiedler; Thomas Pongratz; Wolfgang Beyer; Georg Hennig; Adrian Rühm; Wael Khoder

doi:10.1117/12.2037852

4 March 2014 Investigation on the smoke development during Laparoscopic surgery

Ronald Sroka, Sebastian Fiedler, Thomas Pongratz, Wolfgang Beyer, Georg Hennig, Adrian Rühm, Wael Khoder

Proceedings Volume 8926, Photonic Therapeutics and Diagnostics X; 89261D (2014) https://doi.org/10.1117/12.2037852
Event: SPIE BiOS, 2014, San Francisco, California, United States

Abstract

Objective: During laser assisted laparoscopic intervention smoke occurs reducing the clear vision to the target. Simply smoke suction is not possible with respect to deflating / enflating capabilities of the belly. Thus the clinical question arise if the use of different wavelength may show similar smoke development or whether is it possible to reduce the smoke development by wavelength selection. Materials and Methods: Tissue test model was “Bavarian Leberkäse”. A special container set-up was created to collect the laser induced smoke. Smoke was suctioned through a capillary. The amount of light scattered by the smoke particles when flowing through this capillary was measured. Ablation parameter was continuous mode and10W at the end of a 400μm bare fibre for the wavelengths 980nm, 1350nm and 1470nm. Additional the optical transmission was measured. The vaporized tissue volume was measured. Results: Light scattering, optical parameters and vaporized tissue volume were correlated. Measurement showed reproducible results. While the time to get first signal of scattered light in case of 1470nm is shorter compared the other wavelength, the ratio of scatter-signal to ablation rate showed only a trend increase when longer wavelength were used. Conclusion: Tissue absorbers and carbonized tissue properties are relevant for smoke development resulting in an increased SI / AR ratio trend. Thus the expert physician in laparoscopic intervention should also be an expert in lasertissue interaction. Cutting without carbonization gained advantages.

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Ronald Sroka, Sebastian Fiedler, Thomas Pongratz, Wolfgang Beyer, Georg Hennig, Adrian Rühm, and Wael Khoder "Investigation on the smoke development during Laparoscopic surgery", Proc. SPIE 8926, Photonic Therapeutics and Diagnostics X, 89261D (4 March 2014); https://doi.org/10.1117/12.2037852

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KEYWORDS

Tissues

Laparoscopy

Laser ablation

Surgery

Light scattering

Laser therapeutics

Laser tissue interaction

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