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Thulium laser in interventional endoscopy: animal and human studies
Gian E Tontini1, Helmut Neumann2, Luca Pastorelli1
1Gastroenterology and Digestive Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
Endoscopy
|January 21, 2017
Summary
The thulium laser system (TLS) precisely stops bleeding in the upper gastrointestinal tract with minimal tissue damage. This new endoscopic tool shows promise for complex bleeding cases.
Area of Science:
- Gastroenterology
- Surgical Technology
- Laser Medicine
Background:
- The thulium laser system (TLS) utilizes a 2-μm wavelength, offering a shallow coagulation depth (0.2–0.4 mm) to minimize collateral tissue injury.
- This study evaluates the feasibility of TLS for endoscopic hemostasis, comparing its efficacy and safety against argon plasma coagulation (APC) in ex vivo animal models.
- It also reports the initial in vivo application of TLS for human hemostatic treatments.
Observation:
- Ex vivo animal models demonstrated no deep submucosal injury with TLS.
- TLS exhibited controlled penetration depth, with minimal vertical (0.1–2.0 mm) and lateral (0.1–0.7 mm) tissue damage, varying by power settings and fiber diameter (365-µm and 550-µm).
Findings:
- In vivo hemostasis using TLS in three human patients with complex nonvariceal upper gastrointestinal bleeding was consistently successful.
- No complications were reported during or after the endoscopic hemostasis procedures in the human subjects.
Implications:
- The thulium laser system (TLS) is a precise and user-friendly tool for interventional endoscopy.
- TLS presents a promising novel technique for managing gastrointestinal bleeding, potentially improving patient outcomes and reducing procedure-related risks.
