Abstract
Endoluminal surgery for the treatment of colorectal neoplasia is typically carried out using electrocautery tools which imply limited precision and the risk of harm through collateral thermal damage to the adjacent healthy tissue. As a potential alternative, we present the successful colonic epithelial laser ablation by means of picosecond laser pulses. Laser ablation studies performed in ex-vivo colon tissue result in cavities with comparable thickness to early stage colorectal cancers. The corresponding histology sections exhibit only minimal collateral damage to the surrounding tissue and the depth of the ablation can be controlled precisely by means of the pulse energy. High-speed imaging has been used for the first time to visualize picosecond laser ablation of cancerous tissue in a clinically relevant model. This information was correlated with histopathology and optical surface profilometry revealing the dynamic nature of the laser tissue interaction and the need for temporal or spatial separation of pulses for optimum efficacy with regards to tissue removal. Overall, the application of picosecond laser pulses to ablate endoluminal bowel lesions demonstrates significantly improved precision and reduced thermal damage to the adjacent tissue in comparison to conventional procedures and hence will enable more precise surgical treatment of cancers.
Highlights
Endoluminal surgery for the treatment of colorectal neoplasia is typically carried out using electrocautery tools which imply limited precision and the risk of harm through collateral thermal damage to the adjacent healthy tissue
The results presented show that ultrashort laser pulses enable a welldefined mucosal ablation of cavities with comparable thickness to early stage colorectal cancer
The depth of the laser ablation can be controlled by means of the pulse energy and thicker tissue regions can be removed sequentially using multiple scans
Summary
Endoluminal surgery for the treatment of colorectal neoplasia is typically carried out using electrocautery tools which imply limited precision and the risk of harm through collateral thermal damage to the adjacent healthy tissue. The application of picosecond laser pulses to ablate endoluminal bowel lesions demonstrates significantly improved precision and reduced thermal damage to the adjacent tissue in comparison to conventional procedures and will enable more precise surgical treatment of cancers. Endoluminal surgery for the treatment of early colorectal neoplasms (adenomas and malignant polyps) is typically based on conventional diathermic techniques which imply restrictions on precision and the risk of harm through collateral thermal damage to the surrounding healthy tissue, resulting in bowel perforation. As a potential alternative to mitigate these risks, we present the successful laser ablation of colorectal polyps and healthy intestine with high accuracy and only very minimal impact on the adjacent tissue by means of picosecond pulsed lasers. The reported tissue removal rate for ex-vivo brain tissue is 2 m m3/min
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