Abstract
Interventional laser-induced thermal therapy (LITT) is an emerging technique to treat popliteal synovial cysts. The goal of LITT is coagulation and subsequent obliteration of inosculation and cystic cavity under local tumescent anesthesia. Ultrasound is an imaging method used for LITT. Analyzing the results of the use of laser obliteration of Baker's cyst, the authors concluded that obliteration of solely the cystic popliteal cavity can provide persistent recovery. As expected, in any invasive procedure, there are some procedure-related adverse events or complications.
Highlights
The findings were helpful for identifying surgical solution and laser induced thermal therapy was offered for the patient who provided written informed consent
Surrounding tissues of the subcutaneous fat saturated with water solution of local anesthetic contribute to higher hydration and capacity to absorb radiation at wavelength of 1.47 mcm resulting în considerable overheating effect
Tumescent anesthesia fails to provide substantial anesthetic effect because major pain receptors of the cyst wall are located în the medium layer, close to capillary net and the solid external cyst wall prevents lidocaine diffusion [7]
Summary
Baker’s cyst is a benign synovial mass. The prevalence of the condition among patients seen for knee pains ranges from 3.4 to 32.0 % [1, 2]. There is no single approach to surgical strategy due to specific anatomical location of the entity, vague etiology and pathogenesis [3]. Local laser hyperthermia is used at several outpatient clinics employing collagen denaturation through exposure to direct radiation or secondary heat emittance [4]. The authors used the practice for laser obliteration of Baker’s cyst [5]. Detected several shortcomings and difficulties during surgical interventions în addition to ease and efficacy of the technique. Laser settings were produced empirically for local photocoagulation of the connective tissues and often appeared being not optimal with poorly predictable results. The procedure was associated with a risk of complication including burn of subcutaneous fat tissue due to difficultiues of ultrasound visualization of the fine light pipe through soft tissues [6]
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