Laser wound: (two) mixed-beam (cw Nd:YAG-PW XeCl) lasing results in mixed injuries

Abstract

The POLYCON system has been developed for simultaneous passage of different laser beams to a target. In this study, CW Nd:YAG (9 W/cm<SUP>2</SUP>) and XeCl excimer (30 mJ/pulse, 80 nsec, 10 Hz) laser beams were directed via individual fibers to a cone-shaped optical mixer continuously connected at the site of its outlet aperture with a common flexible cable destined for surgery. Contact mode cuts were made on rat liver and biopsy samples taken for electron microscopy. Injuries of mixed type have been found within the same cells, e.g., mitochondrial ballooning detected recently after Nd:YAG and vesiculation of the endoplasmic reticulum which is a feature characteristic of XeCl excimer laser. Taking into consideration satisfactory cutting properties, good hemostatic effect and favorable prognosis for recovery as evidenced by active phagocytosis along with proteolytic digestibility of debris in the wound, mixed beam lasing with the parameters tested can be approved as a perspective kind of surgery. In one study, a low potential for healing after CW mode Nd:YAG lasing has been revealed by specially devised tests. Contrary to that, the PW mode XeCl laser has been shown to provide better conditions for local recovery not incompatible with the impression of other workers. The excimers are also believed to be good cutters but they are mainly utilized in the experiments on tissues with low blood supply, due presumably to inherent poor hemostatic capacity of these tools. The lasers of that kind would undoubtedly be tried for tissues with high levels of blood supply provided hemostasis could be secured at the site of surgery by some means. In this paper, such a means is offered, and it is a mixed beam system in which XeCl excimer laser is used in the capacity of a cutter while Nd:YAG one is operating to stop bleeding with minimal side effects on healing in the post-operation period.