Comparison of diode laser in soft tissue surgery using continuous wave and pulsed modes in vitro

Abstract

In this study, the interaction between diode laser radiation and chicken soft tissue was studied in vitro by a high-speed digital video camera. We used a diode laser with a wavelength of (980 ± 10) nm and average power of 10 W. The diode laser was operated in continuous wave (CW) and pulsed modes. In CW mode, the average laser radiation power was 10 W; in pulsed mode, the average laser radiation power was 10 W and the peak power was 20 W. Diode laser radiation was delivered to soft tissue (chicken meat) using a quartz optical fiber with either a clear distal end (clear tip) or a distal end containing an optothermal converter (hot tip). Application of the diode laser in pulsed mode resulted in crater depths and areas of collateral damage in soft tissue about 1.6 times greater than those observed in CW mode at treatment with the clear tip. Significant differences in the crater depth and collateral damage width of chicken meat were not found after hot-tip treatment with the diode laser in CW and pulsed modes. Soft tissue treated with the hot tip showed crater depths about 3.4 times greater than those observed after treatment with the clear tip. Hot tip treatment further resulted in collateral damage widths about 2.7 times lower than those obtained after treatment with the clear tip.

Graphical abstract

Keywords

diode laser / thermo-optically powered surgery / hot tip surgery / laser surgery / soft tissue

Andrey V. Belikov graduated in 1990 from Saint-Petersburg Institute of Fine Mechanics and Optics (SPIFMO), specialty optics. His professional experience and positions: 1990–1993, post-graduate student of Quantum Electronics and Biomedical Optics Department of SPIFMO; 1993–2002, Ph.D., senior researcher of Quantum Electronics and Biomedical Optics Department of SPIFMO; 2002–2013, associate Professor of Laser Technique and Biomedical Optics Department of Saint-Petersburg State University of Information Technologies, Mechanics and Optics (SPb SU ITMO); 2013–2015, Professor of Laser Technique and Biomedical Optics Department of Saint-Petersburg National Research University of Information Technologies, Mechanics and Optics (ITMO University); 2015–present, Professor of Laser Technologies and Laser Technique Department of ITMO University.

His professional activities: 6 international projects (optics for medicine), more than 20 international congresses, 5 invited lectures. His research interests are biomedical optics, physics of interaction of light with materials. He has published more than 150 papers.

Alexei V. Skrypnik graduated in 1991 from Saint-Petersburg Institute of Fine Mechanics and Optics (SPIFMO), specialty optics. His professional experience and positions: 1991–1994, post-graduate student of Quantum Electronics and Biomedical Optics department of SPIFMO; 1994–2003, Ph.D., senior researcher of Quantum Electronics and Biomedical Optics department of SPIFMO; 2003–2015, associate Professor of Laser Technique and Biomedical Optics Department of Saint-Petersburg National Research University of Information Technologies, Mechanics and Optics (ITMO University); 2015–present, associate Professor of Laser Technologies and Laser Technique Department of ITMO University.

His professional activities: 3 international projects (optics for medicine), more than 18 international congresses. His research interests include biomedical optics, physics of interaction of light with materials, nanotechnologies. He has published more than 100 papers.

Ksenia V. Shatilova graduated in 2009 from Saint-Petersburg State University of Information Technologies, Mechanics and Optics (SPb SU ITMO), specialty laser technique and laser technologies. Her professional experience and positions: 2009–2014, post-graduate student and assistant of Laser Technique and Biomedical Optics Department of Saint-Petersburg National Research University of Information Technologies, Mechanics and Optics (ITMO University); 2014–2015, Ph.D., assistant Professor of Laser Technique and Biomedical Optics Department of ITMO University; 2015–present, assistant Professor of Laser Technologies and Laser Technique Department of ITMO University. Her professional activities: 2 international projects (optics for medicine), more than 10 international congresses. Her research interests are biomedical optics, physics of interaction of light with materials, medical laser applications. Now, she has published more than 30 papers.

References

[1] Rai P K. Lasers in Surgery. In: Rai A K, Das I M L, Uttam K N, eds. Emerging Trends in Laser & Spectroscopy and Applications. New Delhi: Allied Publishers, 2010

[2] Chen P S, Kuo C Y, Chen H C, Shih C P, Wang C H. Diode laser-assisted excision of glomus tympanicum tumor: do diode lasers help in hemostasis and tumor removal? Journal of Medical Science, 2013, 33(4): 221–224

[3] Rao G, Tripthi P S, Srinivasan K. Haemostatic effect of CO₂ laser over excision of an intraoral hemangioma. International Journal of Laser Dentistry, 2012, 2(3): 74–77

[4] Pedrosa A, Santos A, Ferreira M, Araújo C, Barbosa R, Medeiros L. Is carbon dioxide laser vaporization a valuable tool in the management of oral leukoplakia? A survey at an oncology hospital. Lasers in Medical Science, 2014, doi: 10.1007/s10103-014-1551-2

[5] He F, Wang Y, Chen W, Zhu Z, Zeng Y, Zhang J, Tang S. Clinical reseach of early laryngocarcinoma treatment by carbon dioxide laser microsurgery. Journal of Clinical Otorhinolaryngology − Head & Neck Surgery, 2014, 28(7): 493–495

[6] Ahmed R, Mohammed G, Ismail N, Elakhras A. Randomized clinical trial of CO₂ LASER pinpoint irradiation technique versus chemical reconstruction of skin scars (CROSS) in treating ice pick acne scars. Journal of Cosmetic and Laser Therapy, 2014, 16(1): 8–13

[7] Giovannacci I, Vescovi P, Mergoni G, Fornaini C, Bonanini M, Meleti M. Pain and health-related quality of life after oral soft tissue surgical interventions: the advantages of the Nd:YAG laser. Journal of Dentistry Indonesia, 2014, 21(2): 58–63

[8] Tanzi E L, Alster T S. Comparison of a 1450-nm diode laser and a 1320-nm Nd:YAG laser in the treatment of atrophic facial scars: a prospective clinical and histologic study. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery, 2004, 30(2 Pt 1): 152–157

[9] Kramer M W, Wolters M, Cash H, Jutzi S, Imkamp F, Kuczyk M A, Merseburger A S, Herrmann T R. Current evidence of transurethral Ho:YAG and Tm:YAG treatment of bladder cancer: update 2014. World Journal of Urology, 2015, 33(4): 571–579

[10] Fornaini C, Raybaud H, Augros C, Rocca J P. New clinical approach for use of Er:YAG laser in the surgical treatment of oral lichen planus: a report of two cases. Photomedicine and Laser Surgery, 2012, 30(4): 234–238

[11] Sanz-Moliner J D, Nart J, Cohen R E, Ciancio S G. The effect of an 810-nm diode laser on postoperative pain and tissue response after modified Widman flap surgery: a pilot study in humans. Journal of Periodontology, 2013, 84(2): 152–158

[12] Das D, Reed S, Klokkevold P R, Wu B M. A high-throughput comparative characterization of laser-induced soft tissue damage using 3D digital microscopy. Lasers in Medical Science, 2013, 28(2): 657–668

[13] Beer F, Körpert W, Passow H, Steidler A, Meinl A, Buchmair A G, Moritz A. Reduction of collateral thermal impact of diode laser irradiation on soft tissue due to modified application parameters. Lasers in Medical Science, 2012, 27(5): 917–921

[14] Romanos G, Nentwig G H. Diode laser (980 nm) in oral and maxillofacial surgical procedures: clinical observations based on clinical applications. Journal of Clinical Laser Medicine & Surgery, 1999, 17(5): 193–197

[15] Qafmolla A, Bardhoshi M, Gutknecht N, Bardhoshi E. Evaluation of early and long term results of the treatment of mucocele of the lip using 980 nm diode laser. European Scientific Journal, 2014, 10(6): 334–340

[16] Borchers R. Comparison of diode lasers in soft-tissue surgery using CW-and superpulsed mode: an in vivo study. Dissertation for the Master Degree. Aachen: RWTH Aachen University, 2008, 25–55

[17] Bogdan Allemann I, Goldberg D J, eds. Basics in dermatological laser applications. In: Itin P, Jemec G, eds. Current Problems in Dermatology. Vol 42. Basel: Karger, 2011

[18] Grunewald S, Bodendorf M O, Simon J C, Paasch U. Update dermatologic laser therapy. Journal of the German Society of Dermatology : JDDG, 2011, 9(2): 146–159

[19] Vinay Varkey A. Fiber based infrared lasers and their applications in medicine, spectroscopy and metrology. Dissertation for the Doctoral Degree. Ann Arbor: University of Michigan, 2013

[20] Altshuler G B. Thermo-optically powered (TOP) surgery: a new opportunity for the dental practice. In: Proceedings of 19th Annual Conference of the Academy of Laser Dentistry. Scottsdale, 2012

[21] Dental Photonics, Inc. Alta-ST Soft Tissue Surgical Modular System User Manual, 2013

[22] Bashkatov A N, Genina E A, Kochubey V I, Tuchin V V. Optical properties of human skin, subcutaneous and mucous tissues in the wavelength range from 400 to 2000 nm. Journal of Physics D, Applied Physics, 2005, 38(15): 2543–2555

[23] Vogel A, Venugopalan V. Mechanisms of pulsed laser ablation of biological tissues. Chemical Reviews, 2003, 103(2): 577–644

[24] Roggan A, Friebel M, Doerschel K, Hahn A, Mueller G J. Optical properties of circulating human blood. Proceedings of SPIE, 1998, 3195: 51–63

[25] Bashkatov A N, Genina E A, Tuchin V V. Optical properties of skin, subcutaneous, and muscle tissues: a review. Journal of Innovative Optical Health Sciences, 2011, 04(01): 9–38

[26] Capon A, Mordon S. Can thermal lasers promote skin wound healing? American Journal of Clinical Dermatology, 2003, 4(1): 1–12

[27] Skripnik A. Opto-thermal fiber converter of laser radiation. Izvestiya vuzov. Pribiristroenie, 2013, 56(9): 37–42

[28] Belikov A V, Feldchtein F I, Altshuler G B. Dental surgical laser with feedback mechanisms. Pat. US 2012/0123399 A1/ №  13/379,916; appl. 31.12.2010; pub. 17.05. 2012

[29] Altshuler G B, Belikov A V, Skrypnik A V, Feldchtein F. Thermo−optical surgery: a new minimally invasive method of contact soft tissue surgery. Innovative Dentistry, 2012, 1: 2–12

[30] Yusupov V I, Chudnovskii V M, Bagratashvili V N. Laser−induced hydrodynamics in water−saturated biotissues: 1. generation of bubbles in liquid. Laser Physics, 2010, 20(7): 1641–1646

[31] Yusupov V I, Chudnovskii V M, Bagratashvili V N. Laser−induced hydrodynamics in water−saturated biotissues: 2. effect on delivery fiber. Laser Physics, 2011, 21(7): 1230–1234

[32] Bagratashvili V N, Yusupov V I, Chudnovskii V M. Laser−induced hydrodynamics nearby optical fiber tip. In: Proceedings of III International Symposium Topical Problems Of Biophotonics, 2011, 269

[33] Yusupov V I, Chudnovskii V M, Bagratashvili V N. Laser−Induced Hydrodynamics in Water and Biotissues Nearby Optical Fiber Tip. In: Schulz H, ed. Hydrodynamics − Advanced Topics. Croatia: InTech, 2011, 97–119

[34] Beer F, Körpert W, Buchmair A G, Passow H, Meinl A, Heimel P, Moritz A. The influence of water/air cooling on collateral tissue damage using a diode laser with an innovative pulse design (micropulsed mode)-an in vitro study. Lasers in Medical Science, 2013, 28(3): 965–971

[35] Dasgupta D, Demichelis F, Pirri C F, Tagliaferro A. π bands and gap states from optical absorption and electron-spin-resonance studies on amorphous carbon and amorphous hydrogenated carbon films. Physical Review B: Condensed Matter, 1991, 43(3): 2131–2135

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