Transoral Robotic Surgery using the Thulium-YAG Laser: A Prospective Study

✍ Scribed by Kathryn M. Van Abel; Eric J. Moore; Matthew L. Carlson; Jennifer A. Davidson; Jaoquin J. Garcia; Steven M. Olsen; Kerry D. Olsen

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 650 KB
• Volume: 121
• Category: Article
• ISSN: 0023-852X
• DOI: 10.1002/lary.22253

✦ Synopsis

Early reports using TORS uniformly described the use of monopolar electrocautery (EC) to perform surgical resection due to the lack of a robust flexible laser fiber. This prompted investigation into a new laser design: the thulium-doped yttrium-aluminum-garnet (Tm:YAG) laser (RevoLixTM, Lisa Laser Products,. Katlenburg, Germany) 9 . The is a diode-pumped solid-state laser with a yttrium-aluminum-garnet rod 9, 10 . The Tm:YAG laser produces a continuous-wave beam with a wavelength of 2 µm 9, 10 , allowing for smooth incision and vaporization of tissue 10 . It results in a depth of tissue penetration of only 0.25mm, decreasing the risk of serious tissue damage 10,14 . Similar to the CO 2 laser, the target chromophore of the Tm:YAG laser is water, which, due to its temperature stability, retains its absorption properties when heated by the laser. Finally, laser energy can be delivered through a flexible glass fiber 9,10,14 .

Our goal for this study was to assess the feasibility, safety and 30-day functional outcome associated with use of the Tm:YAG laser during TORS (TY:TORS, Figure 1, 2) by direct comparison with the current gold standard, TORS using electrocautery (EC:TORS), via a matched case-control study.