Selective mucosal ablation using CO2 laser for the development of novel endoscopic submucosal dissection: comparison of continuous wave and nanosecond pulsed wave

K. Ishii; S. Watanabe; D. Obata; H. Hazama; Y. Morita; Y. Matsuoka; H. Kutsumi; T. Azuma; K. Awazu

doi:10.1117/12.842426

11 February 2010 Selective mucosal ablation using CO₂ laser for the development of novel endoscopic submucosal dissection: comparison of continuous wave and nanosecond pulsed wave

K. Ishii, S. Watanabe, D. Obata, H. Hazama, Y. Morita, Y. Matsuoka, H. Kutsumi, T. Azuma, K. Awazu

Author Affiliations +

Proceedings Volume 7562, Optical Interactions with Tissues and Cells XXI; 75620Q (2010) https://doi.org/10.1117/12.842426
Event: SPIE BiOS, 2010, San Francisco, California, United States

Abstract

Endoscopic submucosal dissection (ESD) is accepted as a minimally invasive treatment technique for small early gastric cancers. Procedures are carried out using some specialized electrosurgical knifes with a submucosal injection solution. However it is not widely used because its procedure is difficult. The objective of this study is to develop a novel ESD method which is safe in principle and widely used by using laser techniques. In this study, we used CO₂ lasers with a wavelength of 10.6 μm for mucosal ablation. Two types of pulse, continuous wave and pulsed wave with a pulse width of 110 ns, were studied to compare their values. Porcine stomach tissues were used as a sample. Aqueous solution of sodium hyaluronate (MucoUp^R) with 50 mg/ml sodium dihydrogenphosphate is injected to a submucosal layer. As a result, ablation effect by CO₂ laser irradiation was stopped because submucosal injection solution completely absorbed CO₂ laser energy in the invasive energy condition which perforates a muscle layer without submucosal injection solution. Mucosal ablation by the combination of CO₂ Laser and a submucosal injection solution is a feasible technique for treating early gastric cancers safely because it provides a selective mucosal resection and less-invasive interaction to muscle layer.

Citation Download Citation

K. Ishii, S. Watanabe, D. Obata, H. Hazama, Y. Morita, Y. Matsuoka, H. Kutsumi, T. Azuma, and K. Awazu "Selective mucosal ablation using CO₂ laser for the development of novel endoscopic submucosal dissection: comparison of continuous wave and nanosecond pulsed wave", Proc. SPIE 7562, Optical Interactions with Tissues and Cells XXI, 75620Q (11 February 2010); https://doi.org/10.1117/12.842426

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