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Session: Medical Instruments - Surgery I
Session starts: Friday 25 January, 10:30
Presentation starts: 11:45
Room: Lecture room 557

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Ruud Verdaasdonk (VU University Medical Center)
Albert van der Veen (VU University Medical Center)
Ivo van Eibergen Santhagens (VU University Medical Center)
Tjeerd de Boorder (University Medical Center Utrecht)

Abstract:
The continuous wave 2 µm laser has proven to be a versatile tool for controlled ablation or cutting of tissue with hemostasis and minimal carbonisation due to effective tissue water vaporisation. The 2 µm wavelength can be considered ‘eye safe’ and fiber delivery enables endoscopic application in both air and water. To improve the practical application in various endoscopic and robotic surgical procedures, the fiber delivery system was adapted by shaping the fiber tip for better control of the beam direction and enhancement of the tissue effect. The optical characteristics of tapered, ball shaped and angled fiber tips and the ablation effects in tissues were studied using high speed and thermal imaging techniques. Beam properties were also analysed by ray-tracing. The modified tips were applied during surgery in the lungs to ablate diseased mucosa on the trachea wall, resection of tumors in the tongue and, in neurosurgery for 3rd ventriculostomy to treat hydrocephalus. Due to an instant cyclic phase change between water and vapour, the beam direction can change dramatically and has to be accounted for in tip design and potential damage during clinical application. The tapered shape enabled precise contact surgery. An angled ball shape provides controlled side irradiation of the wall during endoscopic procedures e.g. in the trachea. Modified fiber tips improve the control and versatility of the cw 2 µm laser for various clinical applications.