Interstitial laser coagulation of the prostate: experimental studies

Thomas A. McNicholas; Adrian C. Steger M.D.; Stephen G. Bown; Neil O'Donoghue

doi:10.1117/12.43901

1 July 1991 Interstitial laser coagulation of the prostate: experimental studies

Thomas A. McNicholas, Adrian C. Steger M.D., Stephen G. Bown, Neil O'Donoghue

Proceedings Volume 1421, Lasers in Urology, Laparoscopy, and General Surgery; (1991) https://doi.org/10.1117/12.43901
Event: Optics, Electro-Optics, and Laser Applications in Science and Engineering, 1991, Los Angeles, CA, United States

Abstract

A percutaneous, low power, interstitial method of controlled tissue coagulation by laser light has been developed and assessed as a possible alternative to existing therapy for benign and malignant prostatic disease. For prostate cancer this technique may be of importance when the tumor volume is small and well defined, particularly as these tumors can increasingly be identified by transrectal ultrasound (TRUS) and are unlikely to have metastasised. The possibility therefore arises of destruction of such small lesions in situ, thereby avoiding the need for radical surgery or radiotherapy. Using the male beagle prostate model, one or more 150-400 micron fibers was implanted within the substance of the prostate through which a Yttrium Aluminum Garnet (YAG) laser energy could be transmitted. Using long exposures and lower powers than used in routine endoscopic laser therapy, well-defined areas of coagulative necrosis could be created without extensive tissue charring or damage to the fiber. For an energy dose of 1000J a lesion approximately 1 cm in diameter results at four days. The ultrasound scanning methods can detect the fiber(s) and the area(s) of coagulation. At 6/52 months following treatment, healing was by fibrosis or cystic degeneration. There were no ill effects on the subjects following coagulation of the prostate. Multiple fiber experiments produced larger volume lesions relevant to more extensive cancer or for the coagulation of benign adenomatous hyperplasia causing outflow symptoms. Ultrasound guided clinical treatments in patients with cutaneous metastases or hepatic and pancreatic tumors have confirmed the experimental results so far obtained. The technique may prove of value for the destruction of early, small, focal tumors of the prostate and for the treatment of moderate benign enlargement. Clinical trial for both benign and malignant disease has commenced.

Citation Download Citation

Thomas A. McNicholas, Adrian C. Steger M.D., Stephen G. Bown, and Neil O'Donoghue "Interstitial laser coagulation of the prostate: experimental studies", Proc. SPIE 1421, Lasers in Urology, Laparoscopy, and General Surgery, (1 July 1991); https://doi.org/10.1117/12.43901

ACCESS THE FULL ARTICLE

INSTITUTIONAL
Select your institution to access the SPIE Digital Library.

SELECT YOUR INSTITUTION

PERSONAL
Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.

PERSONAL SIGN IN

No SPIE Account? Create one

PURCHASE THIS CONTENT

SUBSCRIBE TO DIGITAL LIBRARY

50 downloads per 1-year subscription

Members: $195

Non-members: $335 ADD TO CART

25 downloads per 1 - year subscription

Members: $145

Non-members: $250 ADD TO CART

PURCHASE SINGLE ARTICLE

Includes PDF, HTML & Video, when available