Wassergekühlte Laserversiegelung von Lungengewebe am ex vivo ventilierten Schweinelungenmodell

Abstract

It could be shown in the ex-vivo lung model that laser sealing of parenchymal leaks is improved by simultaneous cooling during laser application. Non cooled laser sealing seems to heat up the tissue abruptly and create carbonisation followed by multiple ruptures of alveola and small airways. In accordance with our clinical experience this experimental study confirms that laser sealing for pneumostasis after metastasectomy can be improved by simultaneously cooling the resection area when treated with the laser.

BipoJet Scissors as an Alternative to Laser in Lung Wedge Resection

“…We have previously reported that overheating of tissue (>180°C) leads to carbonization. The pneumostatic effect is thus decreased and air fistulas increase in size [ 10 ].…”

“…Laser resection of lung metastases has long been promoted in the scientific literature [ 7 , 13 ] as well as in the lay press and on the internet [ 14 , 15 ]. Laser metastasectomy significantly reduces the loss of parenchyma, although the oncologic benefit of laser resection over high-frequency resection or conventional clamp resection has never been proven to be significantly superior [ 5 , 6 , 10 ].…”

“…The literature states that the increase in temperature occurring in the surrounding lung tissue during laser resection allegedly adds an additional oncologic gain in terms of safety margins [ 10 ].…”

“…If the tissue is heated with the applicator to temperatures above 180ºC, the tissue proteins carbonize [ 8 , 9 ]. It is preferable to avoid this situation given that it creates an excessively high rate of air leakage and presumably delays the spontaneous healing of the resected surface [ 10 ]. Based on our clinical experience, we use bipolar scissors to resect metastases.…”