EUS-guided Nd:YAG laser ablation of normal pancreatic tissue: a pilot study in a pig model.
BACKGROUND
Laser ablation with a neodymium:yttrium aluminum garnet (Nd:YAG) laser can achieve a high rate of complete tissue necrosis and has been applied as a minimally invasive, palliative option in hepatocellular carcinoma, liver metastasis in colorectal cancer, and malignant thyroid nodules.


OBJECTIVE
To assess the in vivo feasibility of EUS-guided laser ablation with an Nd:YAG laser of normal pancreatic tissue of a porcine model.


METHODS
Prospective investigation.


METHODS
Hospital animal laboratory.


METHODS
Eight pigs.


METHODS
EUS-guided puncture of the pancreatic tail with a laser-beam fiber. An Nd:YAG laser (1.064 nm) was used, with an output power of 2 and 3 W and a total delivered energy of 500 and 1000 J in continuous mode.


METHODS
The 24-hour follow-up of the pigs was focused on clinical and laboratory aspects. Results of histological studies of the pancreas were obtained 24 hours after the procedure on necroscopy tissue.


RESULTS
There were no technical limitations to the performance of the procedure. Tissue necrosis, localized in the pancreatic parenchyma, was observed in all animals on histological examination. The volume of ablation tissue ranged from a mean of 314 mm(3) to 483 mm(3). The ablation area ranged from a mean of 49 mm(2) to 80 mm(2). No major postprocedure complications were recorded, and all the pigs survived at 24 hours.


CONCLUSIONS
Animal study.


CONCLUSIONS
EUS-guided laser ablation of the pancreas with an Nd:YAG laser is feasible in a porcine model.
Di Matteo
Francesco
F
Digestive Endoscopy Unit, Campus Bio-Medico, University of Rome, Rome, Italy. f.dimatteo@unicampus.it
Martino
Margareth
M
Rea
Roberta
R
Pandolfi
Monica
M
Rabitti
Carla
C
Masselli
Grazia Maria Paola
GM
Silvestri
Sergio
S
Pacella
Claudio Maurizio
CM
Papini
Enrico
E
Panzera
Francesco
F
Valeri
Sergio
S
Coppola
Roberto
R
Costamagna
Guido
G
D000818:Animals; D004195:Disease Models, Animal; D019160:Endosonography / Q000379:methods*; D005240:Feasibility Studies; D005500:Follow-Up Studies; D021621:Imaging, Three-Dimensional; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D010179:Pancreas / Q000000981:diagnostic imaging / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D013552:Swine