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  Heat Generation During Ablation of Porcine Skin With Erbium:YAG Laser vs a Novel Picosecond Infrared Laser

Jowett, N., Wöllmer, W., Mlynarek, A. M., Wiseman, P., Segal, B., Franjic, K., et al. (2013). Heat Generation During Ablation of Porcine Skin With Erbium:YAG Laser vs a Novel Picosecond Infrared Laser. JAMA Otolaryngology—Head & Neck Surgery, 139(8), 828-833. doi:10.1001/jamaoto.2013.3974.

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http://dx.doi.org/10.1001/jamaoto.2013.3974 (Publisher version)
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 Creators:
Jowett, Nathan1, 2, Author
Wöllmer, Wolfgang2, Author
Mlynarek, Alex M.1, Author
Wiseman, Paul3, 4, Author
Segal, Bernard1, Author
Franjic, Kresimir, Author
Krötz, Peter5, Author           
Böttcher, Arne2, Author
Knecht, Rainald2, Author
Miller, R. J. Dwayne5, Author           
Affiliations:
1Department of Otolaryngology–Head and Neck Surgery, McGill University, Montreal, Quebec, Canada , ou_persistent22              
2Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Centre Hamburg–Eppendorf, Hamburg, Germany, ou_persistent22              
3Department of Chemistry, McGill University, Montreal, Quebec, Canada , ou_persistent22              
4Department of Physics, McGill University, Montreal, Quebec, Canada , ou_persistent22              
5Atomically Resolved Structural Dynamics Division, Max Planck Research Department for Structural Dynamics, Department of Physics, University of Hamburg, External Organizations, ou_2173636              

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 Abstract: Importance: Despite significant advances in surgery, most surgical tools remain basic. Lasers provide a means of precise surgical ablation, but their clinical use has remained limited because of undesired thermal, ionizing, or acoustic stress effects leading to tissue injury. A novel ultrafast, nonionizing, picosecond infrared laser (PIRL) system has recently been developed and is capable, in theory, of ablation with negligible thermal or acoustic stress effects. Objective: To measure and compare heat generation by means of thermography during ablation of ex vivo porcine skin by conventional microsecond-pulsed erbium:YAG (Er:YAG) laser and picosecond infrared laser (PIRL). Design and Setting: This study was conducted in an optics laboratory and used a pretest-posttest experimental design comparing 2 methods of laser ablation of tissue with each sample acting as its own control. Intervention: Ex vivo porcine skin was ablated in a 5-mm line pattern with both Er:YAG laser and PIRL at fluence levels marginally above ablation threshold (2 J/cm2 and 0.6 J/cm2, respectively). Main Outcomes and Measures: Peaks and maxima of skin temperature rises were determined using a thermography camera. Means of peak temperature rises were compared using the paired sample t test. Ablation craters were assessed by means of digital microscopy. Results: Mean peak rise in skin surface temperature for the Er:YAG laser and PIRL was 15.0°C and 1.68°C, respectively (P < .001). Maximum peak rise in skin surface temperature was 18.85°C for the Er:YAG laser and 2.05°C for the PIRL. Ablation craters were confirmed on digital microscopy. Conclusions and Relevance: Picosecond infrared laser ablation results in negligible heat generation, considerably less than Er:YAG laser ablation, which confirms the potential of this novel technology in minimizing undesirable thermal injury associated with lasers currently in clinical use.

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Language(s): eng - English
 Dates: 2012-11-212012-10-192012-12-192013-08
 Publication Status: Issued
 Pages: 6
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1001/jamaoto.2013.3974
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Title: JAMA Otolaryngology—Head & Neck Surgery
Source Genre: Journal
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Publ. Info: American Medical Association
Pages: - Volume / Issue: 139 (8) Sequence Number: - Start / End Page: 828 - 833 Identifier: ISSN: 2168-6181
CoNE: https://pure.mpg.de/cone/journals/resource/2168-6181