Application of a Scanner-Assisted Carbon Dioxide Laser System for Neurosurgery

Colasanti, Roberto; Giannoni, Luca; Dallari, Stefano; Liverotti, Valentina; Aiudi, Denis; Rienzo, Alessandro Dı; Rossi, Francesca; Iacoangeli, Maurizio

doi:10.1016/j.wneu.2021.06.085

Cited by 10 publications

(7 citation statements)

References 13 publications

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“…Otherwise, some other laser models are currently being investigated for neurosurgical procedures, such as the 980-nm diode laser and the thuliumdoped yttrium aluminum perovskite (Tm:YAP) crystal laser (17, 18). Colasanti et al show the appliance of a modern CO 2 laser in a variety of cases (19). As we found it more useful for hard or fibrous tissues, this group interestingly has applied laser to pial opening and final excisional bed coagulation among other surgical steps.…”

Section: Discussionmentioning

confidence: 54%

Safeness and efficacy of 2-µm handheld thulium laser during microsurgical resection of supratentorial and infratentorial meningiomas: Experience of a single center

et al. 2022

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AimsWe performed a retrospective nonrandomized study to analyze the results of a microsurgery of intracranial meningiomas using 2-μm thulium flexible handheld laser fiber (Revolix jr).MethodsFrom February 2014 to December 2021, 75 nonconsecutive patients suffering from intracranial meningiomas, admitted in our department, have been operated on with microsurgical technique assisted by 2-μm thulium flexible handheld laser. We have reviewed demographic and clinical data to evaluate safety and efficacy of the technique.ResultsThere were no complications related to the use of the 2-μm thulium laser. We operated on a high percentage of cranial base and tentorial and posterior fossa meningioma in our series. The neurological outcome and degree of resection did not differ from previous series. The neurosurgical team found the laser easy to use and practical for avoiding bleeding and traction.ConclusionThe use of 2-μm thulium fiber handheld flexible laser in microsurgery of intracranial meningiomas seems to be safe and to facilitate tumor resection, especially in “difficult” conditions (e.g., deep seated, highly vascularized, and hard tumors). Even if in this limited retrospective trial the good functional outcome following conventional microsurgery had not further improved, nor the surgical time was reduced by laser, focusing its use on “difficult” (large and vascularized) cases may lead to different results in the future.

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Section: Discussionmentioning

confidence: 54%

Safeness and efficacy of 2-µm handheld thulium laser during microsurgical resection of supratentorial and infratentorial meningiomas: Experience of a single center

et al. 2022

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“…Scanning-aided “free beam” laser surgery is the only technology that enables the surgeon to control the ablation depth and the thermal effect for each scanning passage. Moreover, scanning technology has already been intensively used in many fields of surgery like Gynecology, Colposcopy, Ears-Nose-Throat, Neurosurgery, and General Surgery (i.e., Proctology and Wound Healing) [ 26 , 27 , 28 , 29 , 30 ]. The CO 2 laser can also be delivered using a flexible hollow fiber (i.e., Smartxide2 TRIO System, DEKA, Calenzano, Italy).…”

Section: Methodsmentioning

confidence: 99%

Superficial Peritoneal Endometriosis Vaporization Using a CO2 Laser: A Long-Term Single-Center Experience

Di Michele,

Bramante,

Angioni

et al. 2024

JCM

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Background: The validation of laser usage during laparoscopic procedures, notably by Camran Nezhat in the late 1980s, has been significant. Lasers offer precision and depth control in tissue vaporization without bleeding. Surgical intervention remains central in managing endometriosis-associated pain and infertility, especially for patients unresponsive to hormonal therapy. Methods: This retrospective cohort study included 200 patients with superficial peritoneal endometriosis (SPE) who underwent laparoscopic laser vaporization. Surgery was performed using a CO2 laser, and histological confirmation of endometriosis was obtained for all cases. Pain scores and SF-36 questionnaire domains were assessed preoperatively and postoperatively. Fertility outcomes were evaluated among patients desiring pregnancy. Results: Significant improvements in pain score and SF-36 questionnaire domains were observed postoperatively (p-value < 0.01), indicating enhanced quality of life. Among infertile patients with an active desire for pregnancy, surgical treatment showed an overall pregnancy rate after surgery of 93.7% (p-value < 0.01), including 75.7% natural pregnancies and 24.3% IVF. Laser vaporization enabled precise lesion removal with minimal tissue damage, short operative time, and minimal blood loss. Conclusions: Laparoscopic laser vaporization is an effective treatment for SPE, offering pain relief, improved quality of life, and favorable fertility outcomes. Further research is needed to validate these results in terms of pain control and fertility.

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“…By applying direct radiation with a high-power focused laser, tumorous tissue can be rapidly changed into vaporization and carbonization, thus eliminating the tumorous tissues. In the clinic, laser therapy is mainly applied for the treatment of tumors in the skin 91 and head and neck 92 and in neurology departments 93 , but lasers are also suitable for the treatment of liver 94 , lung 95 , stomach 96 , kidney 97 , intestine 98 and other internal tumors 99 . For the treatment of pancreatic adenocarcinoma, laser ablation under the guidance of endoscopic ultrasonography (EUS) 100 has been introduced, and the results demonstrate that, complete tumor ablation (CTA) was achieved in 94% of the patients in the US-laser ablation group and 100% of the patients in the EUS-laser ablation group (p=0.261).…”

Section: Optical Diagnosis and Therapymentioning

confidence: 99%

The LMIT: Light-mediated minimally-invasive theranostics in oncology

Fan,

Liu,

Gao

et al. 2024

Theranostics

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Minimally-invasive diagnosis and therapy have gradually become the trend and research hotspot of current medical applications. The integration of intraoperative diagnosis and treatment is a development important direction for real-time detection, minimally-invasive diagnosis and therapy to reduce mortality and improve the quality of life of patients, so called minimally-invasive theranostics (MIT). Light is an important theranostic tool for the treatment of cancerous tissues. Light-mediated minimally-invasive theranostics (LMIT) is a novel evolutionary technology that integrates diagnosis and therapeutics for the less invasive treatment of diseased tissues. Intelligent theranostics would promote precision surgery based on the optical characterization of cancerous tissues. Furthermore, MIT also requires the assistance of smart medical devices or robots. And, optical multimodality lay a solid foundation for intelligent MIT. In this review, we summarize the important state-of-the-arts of optical MIT or LMIT in oncology. Multimodal optical image-guided intelligent treatment is another focus. Intraoperative imaging and real-time analysis-guided optical treatment are also systemically discussed. Finally, the potential challenges and future perspectives of intelligent optical MIT are discussed.

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Application of a Scanner-Assisted Carbon Dioxide Laser System for Neurosurgery

Cited by 10 publications

References 13 publications

Safeness and efficacy of 2-µm handheld thulium laser during microsurgical resection of supratentorial and infratentorial meningiomas: Experience of a single center

Safeness and efficacy of 2-µm handheld thulium laser during microsurgical resection of supratentorial and infratentorial meningiomas: Experience of a single center

Superficial Peritoneal Endometriosis Vaporization Using a CO2 Laser: A Long-Term Single-Center Experience

The LMIT: Light-mediated minimally-invasive theranostics in oncology

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