Precision resection of intestine using ultrashort laser pulses

摘要

Endoscopic resection of early colorectal neoplasms typically employs electrocautery tools, which lack precision and run the risk of full thickness thermal injury to the bowel wall with subsequent perforation. We present a means of endoluminal colonic ablation using picosecond laser pulses as a potential alternative to mitigate these limitations. High intensity ultrashort laser pulses enable nonlinear absorption processes, plasma generation, and as a consequence a predominantly non-thermal ablation regimen. Robust process parameters for the laser resection are demonstrated using fresh ex vivo pig intestine samples. Square cavities with comparable thickness to early colorectal neoplasms are removed for a wavelength of 1030 nm and 515 nm using a picosecond laser system. The corresponding histology sections exhibit in both cases only minimal collateral damage to the surrounding tissue. The ablation depth can be controlled precisely by means of the pulse energy. Overall, the application of ultrafast lasers for the resection of intestine enables significantly improved precision and reduced thermal damage to the surrounding tissue compared to conventional electrocautery.