scholarly journals Preliminary Evaluation of Thulium Doped Fiber Laser in Pig Model of Liver Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Maciej Janeczek ◽  
Jacek Świderski ◽  
Albert Czerski ◽  
Bogusława Żywicka ◽  
Jolanta Bujok ◽  
...  
Keyword(s):  
Liver Resection ◽  
Fiber Laser ◽  
Liver Surgery ◽  
Thermal Damage ◽  
Continuous Wave ◽  
Histopathological Analysis ◽  
Swine Model ◽  
Preliminary Evaluation ◽  
Partial Liver Resection ◽  
Liver Transection

Partial liver resection is a treatment of choice for liver tumors; the range of parenchyma excision varies from a small part of the tissue surrounding the neoplasm up to 70% of the organ. One of the major concerns during liver resection is blood loss. Thulium lasers which are characterized by the length of emission wave corresponding to a peak absorption of water create a new possibility of cutting tissues efficiently with minimal thermal damage and concurrently providing a good hemostasis control. The aim of our study was to evaluate an impact of liver transection with thulium doped fiber laser on an intraoperative bleeding and histopathological changes during postoperative period in swine model. Ten animals were subjected to open surgery partial liver resection and an incision of liver tissue with an all-fiber, diode-pumped, and continuous-wave Tm3+-doped fiber laser emitting 37.4 W of output power at ~1.94 μm wavelength. The macroscopic and histopathological evaluation was performed intraoperatively as well as 7 and 14 days after surgery. Macroscopically almost no bleeding was observed during surgery and no signs of bleeding were stated after 7 and 14 days. Histopathological analysis of the transection margin revealed a thermal damage area ranging in depth from 620.23 ± 23.82 μm on the day of surgery to 1817.70 ± 211.98 μm after 7 days. In the samples taken intraoperatively and after 7 days a superficial zone of carbonization was visibly separated from the deeper changes. After 14 days one 765.35 μm deep zone characterized by a granulation was present. In conclusion, thulium doped fiber laser is efficacious in cutting with a narrow zone of thermal injury and provides a good hemostasis during liver transection, thus being a potential tool for oncotic liver surgery.

scholarly journals A Comparative Study of Intraoperative Fluid Management Using Stroke Volume Variation in Liver Resection

2018 ◽  
Vol 103 (3-4) ◽  
pp. 199-206
Author(s):  
K. Kitaguchi ◽  
N. Gotohda ◽  
H. Yamamoto ◽  
S. Takahashi ◽  
M. Konishi ◽  
...  
Keyword(s):  
Liver Resection ◽  
Blood Loss ◽  
Stroke Volume ◽  
Liver Surgery ◽  
Stroke Volume Variation ◽  
Fluid Management ◽  
Control Group ◽  
Fluid Restriction ◽  
Intraoperative Blood Loss ◽  
Liver Transection

Objective: The aim of this study is to examine whether intraoperative fluid management with stroke volume variation (SVV) can achieve safe intravenous fluid restriction and contribute to decreasing intraoperative blood loss in liver surgery. Background: In liver surgery, maintaining the central venous pressure (CVP) at a low level is effective in decreasing intraoperative blood loss. Recently, several studies have suggested that SVV obtained using the FloTrac system demonstrated a better fluid responsiveness than CVP. Methods: We enrolled 30 patients undergoing liver resection since May 2015 in this prospective observational study, and we set the SVV target during liver transection at 13%–20% (SVV group). Forty-three cases of liver resection that we performed between January 2014 and March 2015 without using CVP or SVV were used as the Control group. We compared the 2 groups by using intraoperative blood loss as the primary endpoint. Results: There was no significant difference in patient characteristics between the 2 groups. The mean SVV during liver transection in the SVV group was 15.6 ± 4.4%. The infusion volume until completion of liver transection in the Control group was 9.4 mL/kg/h, whereas that of the SVV group was 3.3 mL/kg/h, a significantly lower volume (P < 0.001). The median intraoperative blood loss was significantly decreased in the SVV group compared with the Control group (391 versus 1068 mL; P < 0.001). The intraoperative transfusion rate was also significantly decreased in the SVV group. Conclusion: We demonstrated that intraoperative management with SVV can achieve safe intravenous fluid restriction and is useful for decrease intraoperative blood loss in liver surgery.

In vivo study of partial liver resection on pigs using a 1.9 μm thulium fiber laser

2011 ◽  
Author(s):  
D. Theisen-Kunde ◽  
H. Wolken ◽  
V. Danicke ◽  
R. Brinkmann ◽  
H. Bruch ◽  
...  
Keyword(s):  
Liver Resection ◽  
Fiber Laser ◽  
In Vivo Study ◽  
Partial Liver Resection ◽  
Thulium Fiber Laser

scholarly journals Local Effects of a 1940 nm Thulium-Doped Fiber Laser and a 1470 nm Diode Laser on the Pulmonary Parenchyma: An Experimental Study in a Pig Model

Materials ◽  
2021 ◽  
Vol 14 (18) ◽  
pp. 5457
Author(s):  
Maciej Janeczek ◽  
Zbigniew Rybak ◽  
Anna Lipińska ◽  
Jolanta Bujok ◽  
Albert Czerski ◽  
...  
Keyword(s):  
Fiber Laser ◽  
Diode Laser ◽  
Cell Activation ◽  
Thermal Damage ◽  
Postoperative Bleeding ◽  
Pig Model ◽  
Histopathological Analysis ◽  
Total Width ◽  
Superficial Zone ◽  
Term Survival

The lungs are a common site of metastases from malignant tumors. Their removal with a minimal but safe tissue margin is essential for the long-term survival of patients. The aim of this study was to evaluate the usefulness of a 1940 nm thulium-doped fiber laser (TDFL) and a 1470 nm diode laser (DL) in a pig model of lung surgery that involved the incision and excision of lung tissue. Histopathological analysis was performed on days 0 and 7 after surgery. Neither TDFL nor DL caused significant perioperative or postoperative bleeding. Histological analysis revealed the presence of carbonized necrotic tissue, mixed fibrin–cellular exudate in the superficial zone of thermal damage and bands of deeper thermal changes. The mean total width of thermal damage on day 0 was 499.46 ± 61.44 and 937.39 ± 109.65 µm for TDFL and DL, respectively. On day 7, cell activation and repair processes were visible. The total width of thermal damage was 2615.74 ± 487.17 µm for TDFL vs. 6500.34 ±1118.02 µm for DL. The superficial zone of thermal damage was narrower for TDFL on both days 0 and 7. The results confirm the effectiveness of both types of laser in cutting and providing hemostasis in the lungs. TDFL caused less thermal damage to the lung parenchyma than DL.

Switchable generation of multi-wavelength continuous wave and square-wave pluses in a bidirectional Erbium-doped fiber laser

2021 ◽  
Vol 143 ◽  
pp. 107302
Author(s):  
Wenxiang Cui ◽  
Xuefang Zhou ◽  
Meihua Bi ◽  
Guowei Yang ◽  
Miao Hu ◽  
...  
Keyword(s):  
Fiber Laser ◽  
Continuous Wave ◽  
Square Wave ◽  
Erbium Doped ◽  
Multi Wavelength

scholarly journals Operative Time, Age, and Serum Albumin Predict Surgical Morbidity After Laparoscopic Liver Surgery

2021 ◽  
pp. 155335062199122
Author(s):  
Daniel Heise ◽  
Jan Bednarsch ◽  
Andreas Kroh ◽  
Sandra Schipper ◽  
Roman Eickhoff ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Surgery ◽  
Postoperative Morbidity ◽  
Operative Time ◽  
Multivariable Analysis ◽  
Operation Time ◽  
Laparoscopic Liver Surgery ◽  
Surgical Morbidity ◽  
Perioperative Morbidity ◽  
Preoperative Albumin

Background. Laparoscopic liver resection (LLR) has emerged as a considerable alternative to conventional liver surgery. However, the increasing complexity of liver resection raises the incidence of postoperative complications. The aim of this study was to identify risk factors for postoperative morbidity in a monocentric cohort of patients undergoing LLR. Methods. All consecutive patients who underwent LLR between 2015 and 2019 at our institution were analyzed for associations between complications with demographics and clinical and operative characteristics by multivariable logistic regression analyses. Results. Our cohort comprised 156 patients who underwent LLR with a mean age of 60.0 ± 14.4 years. General complications and major perioperative morbidity were observed in 19.9% and 9.6% of the patients, respectively. Multivariable analysis identified age>65 years (HR = 2.56; P = .028) and operation time>180 minutes (HR = 4.44; P = .001) as significant predictors of general complications (Clavien ≥1), while albumin<4.3 g/dl (HR = 3.66; P = .033) and also operative time (HR = 23.72; P = .003) were identified as predictors of major postoperative morbidity (Clavien ≥3). Conclusion. Surgical morbidity is based on patient- (age and preoperative albumin) and procedure-related (operative time) characteristics. Careful patient selection is key to improve postoperative outcomes after LLR.

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