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Study finds flexible-fiber CO2 laser safe in endoscopic endonasal transsphenoidal surgery
Date:8/16/2011

(Boston) A new study has shown the Flexible-Fiber CO2 laser to safely cut and coagulate during endoscopic assisted transsphenoidal craniotomies (TSC) without the line of sight problems encountered with conventional CO2 lasers. The findings, reported by researchers from Boston Medical Center (BMC) and Boston University School of Medicine (BUSM), appear in the July/August issue of World Neurosurgery. This is the first study to report the utility of flexible-fiber CO2 laser-assisted ablation in TSC.

The implementation of endoscopy in transsphenoidal surgery for pituitary tumors and other sellar lesions has been one of the most recent significant advances for the treatment of these tumors. This is bolstered by the demonstration of its safety and relative advantages over traditional microscope-based approaches. The long wavelength of the carbon dioxide (CO2) laser has been demonstrated to have high absorption in tissue and water, with rapid conversion of light energy into heat within a small volume of tissue. This property makes the CO2 laser an excellent cutting and ablation tool because it causes minimal thermal damage to adjacent tissue.

The researchers performed a retrospective chart review on 16 patients who underwent flexible-fiber CO2 laser-assisted endoscopic ESS. All tumor pathology types were considered. Results were assessed based on hormone status, tumor size, pathology, complications and resection rates. Pituitary lesions with an average size of 22.7 mm were identified by radiographic and pathologic criteria. The researchers found surgery had a low rate of complication, (three patients) and no laser-related complications were encountered.

According to the authors, because of the small working space, the propensity for bleeding, and the amount of soft tissue and osteogenic dissection involved, the use of flexible-fiber CO2 lasers in ESS is ideal.

Because this is a feasibility and safety study, the author
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Contact: Gina DiGravio
gina.digravio@bmc.org
617-638-8480
Boston University Medical Center
Source:Eurekalert

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