Partial nephrectomy is effective in the treatment of segmental renal disease but hemostasis remains a challenge. In this preliminary investigation the Nd:YAG laser was used alone or as an adjunct to the scalpel in partial nephrectomies to determine if hemostasis could be improved. A technique of 100
Dosimetry study of Nd:YAG laser damage to canine renal cortex
โ Scribed by Theodore V. Benderev; Joan S. Chmiel; Frank A. Carone; Dr. Anthony J. Schaeffer
- Publisher
- John Wiley and Sons
- Year
- 1987
- Tongue
- English
- Weight
- 697 KB
- Volume
- 7
- Category
- Article
- ISSN
- 0196-8092
No coin nor oath required. For personal study only.
โฆ Synopsis
A dosimetry study of factors affecting the extent of tissue damage inflicted upon the canine renal cortex by the Neodymium:Yttrium Aluminum Garnet (Nd:YAG) laser was undertaken. Laser parameters and renal tissue conditions were varied independently in duplicate in the following manner: (1) power -5, 10, 20, 50, 75, 100 watts with a spot size of 1.2 mm; (2) exposure duration -1, 2 , and 4 seconds;
(3) kidney perfusion and temperaturerenal artery unclamped (perfused) without cooling; renal artery clamped (non-perfused) without cooling; and renal artery clamped with cooling. Five days following application of the laser, the animals were sacrificed and serial sections of the renal cortex were examined for maximum depth and width of tissue damage and ablation. Multiple linear regression analysis of the data indicated a direct linear relationship between the joules (watts x seconds) of energy delivered to the renal cortex and the depth and width of tissue damage and ablation (p<O.OOl for joule regression coefficient for each variable). Seconds andlor watts alone were not major predictors of the outcome after accounting for joules. Clamping the main renal artery significantly reduced the depth and width of laser damage when compared to the perfused kidney (p<O.001 for each variable). The depth of damage was similar in the cooled and the noncooled non-perfused kidney.
These data suggest that increased laser energy and kidney perfusion significantly increase renal cortical laser induced damage. Adjustment of these parameters may permit controlled tumor ablation or tissue incision with minimal damage to adjacent normal tissue.
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