Partial nephrectomy using the Nd: YAG laser: A comparison of the 1.06 μ and 1.32 μ lasers employing different delivery systems

D. E. Johnson, K. I. Wishnow, A. C. Von Eschenbach, David Grignon, A. G. Ayala

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

A comparative study of the 1.06 μ and the 1.32 μ Nd:YAG laser using a variety of delivery systems (focusing handpiece, freehand GI quartz fiber, or frosted laser scalpel) was undertaken to determine the usefulness of these modalities in performing partial nephrectomies in dogs. Variables evaluated included total operative time, total joules expended, estimated amount of blood loss, and extent of renal tissue damage. The contact laser scalpel provided the greatest precision and speed, but no hemostasis, and is therefore inappropriate for parenchymal renal surgery. Evaluation of the other delivery systems showed no discernible differences in the extent of renal damage that could be attributed to either wavelength or wattage used. The usual depth of acute renal damage ranged from 1.0 mm to 1.8 mm when tissue was fixed immediately after completing the polar nephrectomy, but the damage had extended to 3.0 mm when tissue was examined after 6 weeks. No consistent differences in extent of cellular damage could be demonstrated between the renal cortex and medulla. The lens system inherent in the focusing handpiece limited the total power (60 watts) that could be employed and surgery proceeded at a slower pace and required a greater expenditure of energy. Likewise, the maximal power that could be applied using the 1.32 μ laser was 25 watts and surgery also proceeded at a slower pace. Therefore, it was concluded that the optimal delivery system studied was the hand-held GI quartz fiber, using the 1.06 μ, which provided maximum wattage, allowing surgery to proceed rapidly with minimal side effects (absence of 'flashing', heat build-up) to the operative personnel and without increased tissue damage to the remaining renal parenchyma.

Original languageEnglish (US)
Pages (from-to)241-247
Number of pages7
JournalLasers in Surgery and Medicine
Volume8
Issue number3
StatePublished - 1988
Externally publishedYes

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Solid-State Lasers
Nephrectomy
Lasers
Kidney
Quartz
Laser Therapy
Operative Time
Hemostasis
Energy Metabolism
Lenses
Hand
Hot Temperature
Dogs

ASJC Scopus subject areas

  • Surgery

Cite this

Partial nephrectomy using the Nd : YAG laser: A comparison of the 1.06 μ and 1.32 μ lasers employing different delivery systems. / Johnson, D. E.; Wishnow, K. I.; Von Eschenbach, A. C.; Grignon, David; Ayala, A. G.

In: Lasers in Surgery and Medicine, Vol. 8, No. 3, 1988, p. 241-247.

Research output: Contribution to journalArticle

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