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Dye-enhanced selective laser ablation for surgical mucosectomy
Y Yamashita1, T Sakai, K Watanabe
1Second Department of Surgery, Fukuoka University, Faculty of Medicine, Fukuoka City, Japan.
Summary
Dye-enhanced photothermal therapy using indocyanine green (ICG) and diode lasers improves surgical endoscopy. This method offers enhanced cutting effects and hemostasis, reducing fibrosis compared to electrocautery.
Area of Science:
- Surgical endoscopy
- Laser surgery
- Photothermal therapy
Background:
- Diode lasers at 805 nm can be enhanced by indocyanine green (ICG) dye, which absorbs light around 800 nm.
- ICG dye enhances the photothermal effect of diode lasers, improving their efficacy as surgical knives.
Purpose of the Study:
- To investigate the dye-enhanced photothermal effect of diode lasers with ICG in surgical endoscopy.
- To evaluate the efficacy and safety of ICG-enhanced laser surgery for mucosal resection.
Main Methods:
- Canine gastric mucosa (9 cm2) was resected using a 10-watt diode laser after submucosal injection of 5 mL ICG solution (0.5 mg/mL).
- Histological examination of canine gastric tissue was performed 10 days post-operation.
- Clinical application involved five patients with rectal adenoma undergoing transanal endoscopic microsurgery (TEM) with a dye-enhanced laser.
Main Results:
- Histological analysis of canine gastric tissue showed less submucosal fibrosis with ICG-enhanced laser treatment compared to electrocautery.
- Mucosal resection in five human patients using the dye-enhanced laser was easily performed.
- The ICG-enhanced laser demonstrated effective hemostasis and excellent tissue-cutting properties.
Conclusions:
- ICG-enhanced diode laser surgery is effective for mucosal resection in surgical endoscopy.
- This technique offers advantages over electrocautery, including reduced fibrosis and improved hemostasis.
- The dye-enhanced laser provides an easy and effective method for tissue cutting and vessel sealing.