The successful laser ablation of clinically relevant tissue models by means of picosecond laser pulses is presented. This is a potential alternative to overcoming limitations of conventional tumour-surgery tools in terms of precision and thermal damage. The correlation of high-speed imaging of the ablation process, schlieren imaging of the resulting plume dynamics and a histopathological analysis of the post-process tissue morphology enables optimisation of the tissue removal rate whilst avoiding adverse cavitation effects. This facilitates minimal collateral thermal damage. Effective tissue removal is presented for the epithelial laser ablation of colonic tissue; with translation of this process towards infiltrating brain and head and neck cancer surgery further discussed.
We are investigating ways to exploit the significant advantages picosecond pulsed lasers can provide for high precision, minimally invasive surgery over conventional surgical tools. Combining a range of characterisation techniques in clinically relevant tissue models, such as high-speed imaging, surface profilometry and histopathological analysis of the laser ablated regions, allows us to control undesirable effects, such as cavitation bubbles, and optimise the ultimate precision achievable. Furthermore, by developing novel, hollow-core optical fibres we have overcome limits imposed by optical damage and non-linear effects delivering peak powers not possible with conventional optical fibres and significantly outperforming state-of-art technologies for laser delivery in surgery. The fundamentals of the laser tissue interactions will be discussed and also our current work on developing the novel optical technologies necessary to move towards devices that could be used in the clinic.
The successful laser ablation of clinically relevant tissue models by means of picosecond laser pulses is presented. This is a potential alternative to overcoming limitations of conventional tumour-surgery tools in terms of precision and thermal damage. The correlation of high-speed imaging of the ablation process, schlieren imaging of the resulting plume dynamics and a histopathological analysis of the post-process tissue morphology enables optimisation of the tissue removal rate whilst avoiding adverse cavitation effects. This facilitates minimal collateral thermal damage. Effective tissue removal is presented for the epithelial laser ablation of colonic tissue; with translation of this process towards infiltrating brain and head and neck cancer surgery further discussed.
Picosecond pulsed lasers can provide significant advantages for high precision, minimally invasive surgery compared to conventional electrocautery tools or utilising continuous wave or long pulsed lasers which can induce high degrees of thermal damage. By combining a range of characterisation techniques such as high-speed imaging, surface profilometry and histopathological analysis of the laser ablated regions we have gained deeper understanding into the dynamics of the plasma-mediated ablation. For example, correlation of time-resolved images with histopathology reveals subtleties about the process such as cavitation effects which must be mitigated in order minimise collateral thermal damage. Additionally, by investigating these phenomena on clinically relevant tissue models we can move towards the realisation of new surgical procedures for more complete removal of disease (such as cancer) from delicate and vital structures within the human body. Such procedures require this high precision to minimise necrotic tissue margins, avoiding severe complications and preserving function. In addition to the fundamentals of laser tissue interactions, novel optical technologies such as beam shaping, micro-optics, imaging and novel fibre optic delivery have also been investigated in order to enable practical and deployable devices.
The successful laser ablation of clinically relevant tissue models by means of picosecond laser pulses is presented. This is a potential alternative to overcome limitations of conventional electrocautery tools in terms of precision and thermal damage. The correlation of high-speed imaging of the process and a histopathological analysis of the post-process tissue morphology enables optimisation of the tissue removal rate whilst avoiding adverse cavitation effects in order to keep the collateral thermal damage to a minimum. Effective tissue removal is presented for the epithelial laser ablation of colonic tissue and the translation of this process towards head and neck surgery and brain surgery is discussed.
Ultrashort pulsed lasers are being increasingly used for high precision micromachining across many industries. To further optimise these processes, consideration of the spatial profile of the laser beam is essential, as the shape of the processed area often closely resembles the intensity distribution used. Within surgical contexts, ultrashort infrared pulsed lasers offer significantly improved localisation in the ablation of biological tissues over current electrocautery methods through their non-contact, plasma-mediated interaction mechanisms. This localisation can reduce the risk of severe complications such as bowel perforation. However, for incorporation into an endoscopic device, the limited focal depths inherent to tightly focused Gaussian beams can greatly hinder the ablation of inhomogeneous tissue surfaces. However, alternative beam shapes, such as Bessel-Gauss beams, enable a decoupling of the focal volume from the focal depth. Various beam profiles and laser scanning parameters have been investigated, capitalising upon the distinct advantages offered from applying ultrashort pulsed lasers to microsurgery of tissue. Assessment of the corresponding ablation profiles in porcine intestinal tissue was performed through both three-dimensional optical surface profilometry and histological analysis. Using a Bessel-Gauss beam, ablated depths close to a millimetre were achieved while showcasing peak thermal damage margins of around 30 µm. If adopted in operating theatres, surgeons could benefit from increased precision when resecting neoplasia in the mucosal and submucosal layers of the colon, providing them with greater levels of control both in terms of lateral accuracy and in moderating the depth of tissue removed, especially when compared to current electrocautery methods.
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