Heat generation during ablation of porcine skin with erbium:YAG laser vs a novel picosecond infrared laser.
OBJECTIVE
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).


METHODS
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.


METHODS
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).


METHODS
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
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.
Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada. nathan.jowett@mail.mcgill.ca
Nathan
N
Jowett
Wolfgang
W
Wöllmer
Alex M
AM
Mlynarek
Paul
P
Wiseman
Bernard
B
Segal
Kresimir
K
Franjic
Peter
P
Krötz
Arne
A
Böttcher
Rainald
R
Knecht
R J Dwayne
RJ
Miller
D000818:Animals; D004817:Epidermis / Q000601:surgery*; D006358:Hot Temperature; D007259:Infrared Rays / Q000009:adverse effects* / Q000627:therapeutic use; D053685:Laser Therapy / Q000009:adverse effects* / Q000379:methods; D053844:Lasers, Solid-State / Q000009:adverse effects* / Q000627:therapeutic use; D023421:Models, Animal; D012680:Sensitivity and Specificity; D013552:Swine; D013817:Thermography / Q000379:methods