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Hemostatic properties of a new cw 2 μm laser scalpel for laparoscopic surgery

Background: Laparoscopic surgery especially relies on hemostatic dissection. In this study, a new laser scalpel suitable for laparoscopic surgery due to its rapid dissection and adequate hemostatic properties is presented. Methods: A Thulium YAG laser system (λ= 2.01 μm) was used at power levels of 15- 20 W transmitted via 365μm core diameter quartz fiber. Arteries and veins of 0.25-3.2 mm inner diameter were coagulated and transected with the laser scalpel in anesthetized pigs, followed by ex vivo measurement of resistance to pressures up to 375 mmHg. Results: Small vessels (<0.5 mm) were successfully occluded up to 100% (arteries) and 89% (veins), larger vessels (1- 2.3 mm) to 74% (arteries) and 65% (veins). At 375 mmHg, 30% of veins and 35% of arteries stayed closed during external pressure measurement. Conclusion: The laser scalpel proved satisfying hemostatic properties for small vessels, for medium-sized vessels alternative coagulating devices must serve as possible back-up.