Design and Preclinical Validation of the Composite-Type Optical Fiberscope for Minimally Invasive Procedures of Intrauterine Disease.
OBJECTIVE
Because of the rapid growth of minimally invasive surgical procedures, we developed an ultrathin fiberscopic imaging system for laser surgery that could be an important instrument for clinical use in an office setting.


RESULTS
A new device, consisting of a custom 1.1-mm diameter flexible fiberscope and ytterbium laser-supported ablation system (composite-type optical fiberscope), has been developed to achieve accurate laser irradiation for minimally invasive procedures of intrauterine disease. This system was validated ex vivo with successful laser ablation under observation. This study provides the design, characterization, performance, and preclinical validation of an optimized composite-type optical fiberscope system. The validation of this fiberscope for endometrial ablation was performed in 12 hysterectomy samples. The irradiated spot diameter and depth were (mean ± SD) 2.80 ± 0.28 mm and 1.53 ± 0.58 mm, respectively, in the range of 185 to 400 J. The effects of the laser on endometrial tissue depended strongly on the combined effects of the output power density and duration of irradiation. The new device makes it possible to perform accurate ablation, because our technology concentrated on combining the 2 subsystems into a single prototype capable of simultaneously observing both the endometrial lesion and the laser spot on a monitor.


CONCLUSIONS
In conclusion, the feasibility and performance of the composite-type fiberscope system were demonstrated in preclinical studies.
Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
Hiroshi
H
Shigetomi
Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
Kiyoshi
K
Oka
Department of Mechanical Engineering, Graduate School of Engineering and Resource Science, Akita University, Akita, Japan.
Takeshi
T
Seki
Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan. Electronic address: hirokoba@naramed-u.ac.jp.
Hiroshi
H
Kobayashi
D000556:Ambulatory Surgical Procedures / Q000295:instrumentation; D055356:Endometrial Ablation Techniques / Q000295:instrumentation*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007564:Japan; D053685:Laser Therapy / Q000295:instrumentation*; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D055100:Optical Fibers; D014591:Uterine Diseases / Q000601:surgery*
Ablation; Composite-type optical fiberscope; Fiberscope; Laser; Minimally invasive procedure