Safety and efficacy of Neodymium-Yag laser photocoagulation: an experimental study in dogs

Acute and chronic experiments were carried out in 26 beagle dogs to study the safety and efficacy of Neodymium-Yag laser photocoagulation in the treatment of bleeding gastric lesions. Continuous high power (50-60 W) Neodymium-Yag laser photocoagulation applied to the exposed stomach of the dog produced evaporation lesions that reached the muscle layer after six to 10 seconds and caused free perforation after 10 to 12 seconds. The tissue damage caused by these long lasting exposures was closely related to the working distance. Moreover, long pulses of high power photocoagulation were not always effective in stopping experimentally induced gastric bleedings. Short pulses (1/2-1 s) of very high power (60-70 W) caused less tissue evaporation, which reached the muscle layers only after 14 to 18 pulses and caused free perforation after 22 to 24 pulses. The tissue damage was not related to the working distance when short pulses were used. Repeated shots of high power Yag laser radiation always resulted in stopping the experimental bleedings without deep injury. It is concluded that high power Neodymium-Yag laser photocoagulation is safe and may be used with success in the treatment of bleeding gastric lesions if the radiation is performed in shots of short duration (1 s or less). Clinical studies in man are warranted and indicated.