Abstract
The current study investigated the hemostatic effect of dual wavelengths on in vivo leporine kidney tissue using 532-nm and 980-nm laser systems. Three irradiation modes, 532 nm, 980 nm, and dual (532 and 980 nm) modes, were compared to test non-contact photothermal hemostasis on 36 bleeders in the kidney models. Each bleeder was flushed with saline during the irradiation. The dual mode achieved complete hemostasis more rapidly than the single modes (4.0 ± 1.4 s for dual vs. no hemostasis for 532 nm and 10.0 ± 1.3 s for 980 nm; p < 0.001). Application of 60 W from the dual wavelengths expanded the surface area of the thermal lesion (up to 60%). In vivo dual-wavelength irradiation achieved more rapid and complete hemostasis with ∼2 mm coagulation depth than the single-wavelength irradiation.
Highlights
Benign prostate hyperplasia (BPH) is the enlargement of stromal cells in the transition zone of the prostate, which commonly occurs in aging men
Various surgical modalities have been used to alleviate lower urinary symptoms related to BPH for resection or coagulation, including transurethral resection of the prostate (TURP), transurethral microwave thermotherapy (TUMT), and high intensity focused ultrasound (HIFU) [1]
The goal of the current research was to validate the feasible hemostasis of dual wavelengths on bleeders in in vivo kidney models for eventual treatment of intraoperative bleeding during laser prostatectomy
Summary
Benign prostate hyperplasia (BPH) is the enlargement of stromal cells in the transition zone of the prostate, which commonly occurs in aging men. Various surgical modalities have been used to alleviate lower urinary symptoms related to BPH for resection or coagulation, including transurethral resection of the prostate (TURP), transurethral microwave thermotherapy (TUMT), and high intensity focused ultrasound (HIFU) [1]. 532-nm laser prostatectomy (photoselective vaporization of the prostate) has been widely accepted as a minimally invasive treatment for BPH because of selective light absorption by hemoglobin, leading to less complications than TURP [2]. Since the prostate has high vasculature, surgical urologists sometimes encounter venous or arterial bleeding during the laser prostatectomy, and the incident rate of intraoperative bleeding is up to 10% [3,4,5]. Once the excessive bleeding continues and impedes vision through a cystoscope, the urologists may have to stop the procedure and convert to electrocautery to achieve complete hemostasis. The conversion to common hemostatic devices is quite cumbersome and may increase the procedure time
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