Picosecond infrared laser ablation results in negligible heat generation, considerably less than Er:YAG laser ablation, which confirms the potential of this novel technology in minimizing undesirable thermal injury associated with lasers currently in clinical use.

Ablation of cortical bone using the PIRL generates negligible and significantly less heat than EYL ablation while preserving cortical microstructure. This novel laser has great potential in advancing surgical techniques where precision osseous manipulation is required.

A comparison of tissue cutting effects in excised cadaver human vocal folds after incisions with three different instruments [scalpel, CO2 laser and the picosecond infrared laser-(PIRL)] was performed. In total, 15 larynges were taken from human cadavers shortly after death. After deep freezing and thawing for the experiment, the vocal folds suspended in the hemilarynx were incised. Histology and environmental scanning electron microscopy (ESEM) analyses were performed. Damage zones after cold instrument cuts ranged from 51 to 135 μm, as compared to 9-28 μm after cutting with the PIRL. It was shown that PIRL incision had smaller zones of tissue coagulation and tissue destruction, when compared with scalpel and CO2 laser cuts. The PIRL technology provides an (almost) atraumatic laser, which offers a quantum jump towards realistic 'micro'-phonosurgery on a factual cellular dimension, almost entirely avoiding coagulation, carbonization, or other ways of major tissue destruction in the vicinity of the intervention area. Although not available for clinical use yet, the new technique appears promising for future clinical applications, so that technical and methodological characteristics as well as tissue experiments seem worthwhile to be communicated at this stage of development.

Objectives/Hypothesis: Conventional lasers ablate tissue through photothermal, photomechanical, and/or photoionizing effects, which may result in collateral tissue damage. The novel nonionizing picosecond infrared laser (PIRL) selectively energizes tissue water molecules using ultrafast pulses to drive ablation on timescales faster than energy transport to minimize collateral damage to adjacent cells. Study Design: Animal cadaver study. Methods: Cuts in porcine laryngeal epithelium, lamina propria, and cartilage were made using PIRL and carbon dioxide (CO₂) laser. Lateral damage zones and cutting gaps were histologically compared. Results: The mean widths of epithelial (8.5 μm), subepithelial (10.9 μm), and cartilage damage zones (8.1 μm) were significantly lower for cuts made by PIRL compared with CO₂ laser (p < 0.001). Mean cutting gaps in vocal fold (174.7 μm) and epiglottic cartilage (56.3 μm) were significantly narrower for cuts made by PIRL compared with CO₂ laser (P < 0.01, P < 0.05). Conclusion: PIRL ablation demonstrates superiority over CO₂ laser in cutting precision with less collateral tissue damage