Partial nephrectomy using the Nd:YAG Laser: A comparison of the 1.06 μ and 1.32 μ lasers employing different delivery systems

Abstract

A comparative study of the 1.06 mu and the 1.32 mu Nd:YAG laser using a variety of delivery systems (focusing handpiece, freehand GI quartz fiber, or frosted laser scalpel) was undertaken to determine the usefulness of these modalities in performing partial nephrectomies in dogs. Variables evaluated included total operative time, total joules expended, estimated amount of blood loss, and extent of renal tissue damage. The contact laser scalpel provided the greatest precision and speed, but no hemostasis, and is therefore inappropriate for parenchymal renal surgery. Evaluation of the other delivery systems showed no discernible differences in the extent of renal damage that could be attributed to either wavelength or wattage used. The usual depth of acute renal damage ranged from 1.0 mm to 1.8 mm when the tissue was fixed immediately after completing the polar nephrectomy, but the damage had extended to 3.0 mm when tissue was examined after 6 weeks. No consistent differences in extent of cellular damage could be demonstrated between the renal cortex and medulla. The lens system inherent in the focusing handpiece limited the total power (60 watts) that could be employed and surgery proceeded at a slower pace and required a greater expenditure of energy. Likewise, the maximal power that could be applied using the 1.32 mu laser was 25 watts and surgery also proceeded at a slower pace.(ABSTRACT TRUNCATED AT 250 WORDS)

Laparoscopic Partial Nephrectomy with a Diode Laser: Porcine Results

“…After use of monopolar electrocautery, the initial thermal lesion of 75 to 500 mm can increase as much as threefold by 6 weeks. 24 The necrotic margin for the diode laser in our study increased from approximately 0.05 cm in the acute kidneys to 0.3 to 0.5 cm in the 2-week survival kidneys.…”

Renal Function after Partial Nephrectomy with the Nd‐YAG Laser Experimental Study in Piglets

“…Landau et al (1987) used a contact Nd:YAG laser with a cone-shaped tip and reported 2.7 mm as the maximal depth of tissue destruction. Johnson et al (1988) used a variety of delivery systems with the Nd : YAG laser in partial nephrectomy in dogs and found maximal acute renal damage up to 1.8 mm. With the frosted tips a portion of the energy is scattered diffusely from the roughened lateral sides of the probe, allowing better coagulating properties (Foster et al, 1988).…”

Use of the holmium:YAG laser in urology

“…34; however, the transected collecting systems did not seal and would have required closure. Although the operating time for polar nephrectomy was longer using the Ho:YAG laser than using the Nd:YAG laser and the GI-free fiber at either 59 or 83 W (4-7 minutes), the total J was considerably lower than the 14,136-18,067 J required with the Nd: YAG laser [7].…”