Advanced Microspot Microslad for the CO₂ Laser

Abstract

New advances in instrumentation have facilitated the development of a second generation carbon dioxide (CO2) laser microspot micromanipulator. The 710 Acuspot has unique advantages over the previous generation of microspots. The compact design is easier to handle and has attachment points for sterile draping. The unit produces a spot size of 250 microns at a 400-mm focal length and 160 microns at 250 mm; the maximum de-focus is 3.2 mm at all focal lengths. An innovative dichroic mirror allows use of the laser unit's own HeNe laser as the aiming beam, eliminating possible aiming error introduced with a virtual image-aiming system. The dichroic mirror also allows better light transmission, resulting in a brighter field of view. As with first generation microspots, the laser beam path is coincident with the microscope optical path, eliminating parallax; this feature has been especially advantageous in pediatric and otologic cases. Having used this unit for 6 months on more than 50 patients, we now consider the use of a microspot to be our delivery system of choice for most microlaryngeal laser surgical applications.

Wound healing and collagen thermal damage in 7.5-?sec pulsed CO2 laser skin incisions

“…A variety of methods have been studied, including the use of a reduced spot size [10], microspot micromanipulators for precise beam delivery, computer-controlled beam delivery [5,11], and modification to the energy pulse duration and repetition rate. Some improvements have been gained through these techniques, but the healing delay remains significant.…”

5 Laser in Larynx, Hypopharynx und Trachea bei gutartigen Erkrankungen

“…B. Accuspot, Fa. Lumenis) [18], die eine besonders feine Fokussierung des Laserstrahls und dadurch eine exakte Schnittführung erlauben. Zur exakten linienförmigen Inzision oder zur oberflächli-chen Koagulation definierter Schleimhautareale oder Schonung der darunter liegenden Gewebe (etwa zur Behandlung der Kehlkopfpapillomatose) eignen sich andererseits besonders Scannersysteme (z.…”

“…Bei optimaler instrumenteller Ausstattung und guter laserchirurgischer Ausbildung des Operateurs sind moderne CO 2 -Lasergerä-te bei Verwendung einer entsprechenden Geräteperipherie (Accuspot) tatsächlich in der Lage, vollkommen atraumatisch und karbonisationsfrei zu schneiden [15,16,18,20,30]. Unter solchen idealen Voraussetzungen sind also CO 2 -Laser durchaus geeignete Instrumente zur Anwendung in der Phonochirurgie.…”

Novel CO2 laser robotic controller outperforms experienced laser operators in tasks of accuracy and performance repeatability

“…2 Despite ongoing refinements in optics, mechanics, and miniaturization of spot size, the basic design of the surgical micromanipulator has been conserved throughout the last 4 decades. 3,4 The current design suffers from several fundamental limitations, including the lack of intrinsic safety mechanisms and a fixed joystick position with minimal potential customization for individual skill level and ergonomics. As with all surgical devices, skill acquisition with the micromanipulator is a gradual process, with both patient safety and surgical outcomes relying solely on the surgeon's acquired proficiency.…”