Hepatic resection with an Nd:YAG laser in pig

Area of Science:

• Hepatobiliary Surgery
• Surgical Technology
• Laser Medicine

Background:

• Traditional hepatic resection methods can lead to significant blood loss and tissue damage.
• Minimally invasive surgical techniques are crucial for improving patient outcomes in liver surgery.

Purpose of the Study:

• To evaluate the efficacy and safety of a divergent Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) laser system for hepatic resections.
• To determine optimal laser parameters for minimizing resection time and ischemic damage during liver surgery.

Main Methods:

• Eleven hepatic resections were performed using a fiberoptic-delivered divergent Nd:YAG laser.
• Different power settings (80 W) and beam divergence angles (4 degrees) were tested.
• Hemostatic effects on venous and parenchymal bleeding were assessed.
• Histological and electron microscopy examinations were conducted.
• Postoperative healing was monitored.

Main Results:

• Optimal parameters (80 W, 4-degree beam divergence) resulted in the shortest resection time and minimal ischemic damage (4 mm).
• The Nd:YAG laser effectively controlled bleeding from veins up to 4.5 mm and reduced parenchymal oozing, minimizing blood loss.
• Histological analysis indicated cellular deterioration and selective organelle destruction in the ischemic layer.
• Elevated hepatic serum enzymes suggested significant cellular damage, yet postoperative examinations showed uncomplicated healing.

Conclusions:

• A divergent Nd:YAG laser transmitted via a flexible fiberoptic system is a viable tool for hepatic resections.
• Optimized laser parameters enhance surgical efficiency and reduce tissue injury.
• The technique provides effective hemostasis and allows for easy surgical manipulation, facilitating uncomplicated healing.