Abstract
OBJECT: Although lasers have proved to be valuable in neuroendoscopy, surgeons are still not comfortable using high-energy laser endoscopic probes in proximity to vital structures such as the basilar artery in third ventriculostomy. The authors have developed a special laser catheter for use in neuroendoscopy; the object of this paper is to present their experimental and clinical experiences using the catheter.
METHODS: This laser catheter is fitted with an atraumatic ball-shaped fiber tip that is pretreated with a layer of carbon particles. These carbon particles absorb approximately 90% of the energy emitted, which is very effectively converted into heat. As the heat is generated in this very thin layer of carbon coating, the temperature at the surface of the ball-shaped tip reaches ablative temperatures instantly at powers of only a few watts per second, which has enabled the authors to limit drastically the amount of laser light used and the length of exposure needed, thereby increasing safety even around critical structures.
CONCLUSIONS: The authors present experimental data and their clinical experience using these pretreated fiber tips with a neodymium-yttrium aluminum garnet contact laser or a diode contact laser in 49 patients (22 males and 27 females) and a variety of procedures: third ventriculocistemostomy (33 patients), cyst fenestration (nine patients), colloid cyst resection (six patients), and fenestration of the septum pellucidum (one patient). There was no instance of mortality or increased morbidity. To date, the procedure success rate is 100% and the overall outcome success rate is 86%. The authors conclude that pretreated atraumatic ball-shaped fiber tips now make laser application safe and effective in a variety of neuroendoscopic procedures. Because of their low power range (only several watts), compact diode lasers will be the energy source of first choice.
| Original language | English |
|---|---|
| Pages (from-to) | 82-92 |
| Number of pages | 11 |
| Journal | Journal of Neurosurgery |
| Volume | 88 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 1998 |
Cite this
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Laser-assisted neuroendoscopy using a neodymium-yttrium aluminum garnet or diode contact laser with pretreated fiber tips. / Vandertop, W P; Verdaasdonk, R M; van Swol, C F.
In: Journal of Neurosurgery, Vol. 88, No. 1, 01.1998, p. 82-92.Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Laser-assisted neuroendoscopy using a neodymium-yttrium aluminum garnet or diode contact laser with pretreated fiber tips
AU - Vandertop, W P
AU - Verdaasdonk, R M
AU - van Swol, C F
PY - 1998/1
Y1 - 1998/1
N2 - OBJECT: Although lasers have proved to be valuable in neuroendoscopy, surgeons are still not comfortable using high-energy laser endoscopic probes in proximity to vital structures such as the basilar artery in third ventriculostomy. The authors have developed a special laser catheter for use in neuroendoscopy; the object of this paper is to present their experimental and clinical experiences using the catheter.METHODS: This laser catheter is fitted with an atraumatic ball-shaped fiber tip that is pretreated with a layer of carbon particles. These carbon particles absorb approximately 90% of the energy emitted, which is very effectively converted into heat. As the heat is generated in this very thin layer of carbon coating, the temperature at the surface of the ball-shaped tip reaches ablative temperatures instantly at powers of only a few watts per second, which has enabled the authors to limit drastically the amount of laser light used and the length of exposure needed, thereby increasing safety even around critical structures.CONCLUSIONS: The authors present experimental data and their clinical experience using these pretreated fiber tips with a neodymium-yttrium aluminum garnet contact laser or a diode contact laser in 49 patients (22 males and 27 females) and a variety of procedures: third ventriculocistemostomy (33 patients), cyst fenestration (nine patients), colloid cyst resection (six patients), and fenestration of the septum pellucidum (one patient). There was no instance of mortality or increased morbidity. To date, the procedure success rate is 100% and the overall outcome success rate is 86%. The authors conclude that pretreated atraumatic ball-shaped fiber tips now make laser application safe and effective in a variety of neuroendoscopic procedures. Because of their low power range (only several watts), compact diode lasers will be the energy source of first choice.
AB - OBJECT: Although lasers have proved to be valuable in neuroendoscopy, surgeons are still not comfortable using high-energy laser endoscopic probes in proximity to vital structures such as the basilar artery in third ventriculostomy. The authors have developed a special laser catheter for use in neuroendoscopy; the object of this paper is to present their experimental and clinical experiences using the catheter.METHODS: This laser catheter is fitted with an atraumatic ball-shaped fiber tip that is pretreated with a layer of carbon particles. These carbon particles absorb approximately 90% of the energy emitted, which is very effectively converted into heat. As the heat is generated in this very thin layer of carbon coating, the temperature at the surface of the ball-shaped tip reaches ablative temperatures instantly at powers of only a few watts per second, which has enabled the authors to limit drastically the amount of laser light used and the length of exposure needed, thereby increasing safety even around critical structures.CONCLUSIONS: The authors present experimental data and their clinical experience using these pretreated fiber tips with a neodymium-yttrium aluminum garnet contact laser or a diode contact laser in 49 patients (22 males and 27 females) and a variety of procedures: third ventriculocistemostomy (33 patients), cyst fenestration (nine patients), colloid cyst resection (six patients), and fenestration of the septum pellucidum (one patient). There was no instance of mortality or increased morbidity. To date, the procedure success rate is 100% and the overall outcome success rate is 86%. The authors conclude that pretreated atraumatic ball-shaped fiber tips now make laser application safe and effective in a variety of neuroendoscopic procedures. Because of their low power range (only several watts), compact diode lasers will be the energy source of first choice.
KW - Adolescent
KW - Adult
KW - Aged
KW - Animals
KW - Brain Diseases/pathology
KW - Catheterization
KW - Child
KW - Child, Preschool
KW - Endoscopes
KW - Endoscopy/methods
KW - Equipment Design
KW - Female
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Laser Coagulation/instrumentation
KW - Lasers
KW - Male
KW - Middle Aged
KW - Neurosurgical Procedures/instrumentation
KW - Rabbits
KW - Surgical Instruments
KW - Time Factors
KW - Treatment Outcome
KW - Ventriculostomy/instrumentation
U2 - 10.3171/jns.1998.88.1.0082
DO - 10.3171/jns.1998.88.1.0082
M3 - Article
VL - 88
SP - 82
EP - 92
JO - Journal of Neurosurgery
JF - Journal of Neurosurgery
SN - 0022-3085
IS - 1
ER -