Observations on the simultaneous use of CO₂ and Nd:YAG lasers in neurosurgery

Abstract

Seven cases of cerebral tumors (four deep-seated sovratentorial gliomas located in motor area, occipital region, parietal region and frontal region; one deep-seated cystic cerebellar spongioblastoma; one sphenoidal wing meningioma, and one spinal cord intradural tumor) were simultaneously irradiated in the same area with two sources (CO2 and Nd:YAG). Using CO2 and Nd:YAG simultaneously, a larger and deeper lesion was obtained. The main bulk was irradiated with two sources free hand. The implant with the two sources was connected to the operating microscope. The rise in temperature, 3 mm from the border of the lesion, was similar to that obtained with Nd:YAG alone. Hemostasis was not impaired. In comparison with the single sources, this method allows a more rapid demolition of the tumor without additional damage to the surrounding tissues.

Intramedullary Spinal Cord Tumors: Part II—Management Options and Outcomes

“…The goals of surgery are to obtain tissue diagnosis, obtain maximum tumor removal, and improve neurologic function while maintaining spinal stability. The surgical management of IMSCT has been greatly facilitated by use of the operative microscope; however, ultrasonography, 17 18 19 20 ultrasonic aspiration, 21 22 and laser 23 have also been instrumental in defining the tumor, and tailoring the appropriate surgical technique by identifying the tumor glial interface, facilitating debulking of the tumor, and ascertaining the presence of residual tumor.…”

Automating neurosurgical tumor resection surgery: Volumetric laser ablation of cadaveric porcine brain with integrated surface mapping

“…Such tooling imparts potentially damaging forces on the surrounding, healthy tissue due to the stress and strain of mechanical separation as these tumors are detached from the adherent adjacent neurovascular structures. Hand‐held surgical laser scalpels show promise in offering a gentle surgical action capable of incision, vaporization, and cauterization but ultimately are difficult to aim due to their invisibility . Naturally, the precision and speed of all these tools is limited to that of their human operator .…”

Extent of thermal penetration of Nd-YAG laser — histological considerations

“…Successful removal of brain tumours with the use of carbon dioxide (CO2) laser has been reported by many investigators, [1,2,3,4,5,9,10,11,13,14,15,16,18,19] who have stressed the advantages of this laser system. Another laser system, neodymium-yttrium aluminum garnet (Nd-YAG) laser, has also been used in gastrointestinal surgery, but rarely in neurosurgery.…”