Laser ablation and associated bubble formation are known to damage biologic tissue. Imaging of tissue straining during ablation would help to understand and control laser-induced damages. We have used polariscopic imaging to monitor the strain induced by pulsed holmium laser irradiation. A photoelastic tissue phantom, poly(acrylamide) gel, whose viscoelastic properties could be controlled was used to mimic various tissues. The laser energy was delivered to the sample via an optical fiber placed either perpendicularly 1.7 mm from the surface or within the sample. Only compressive strain is observed when the bubble is formed within the phantom, whereas significant tensile strain is induced when the bubble is formed at or next to the surface.
Heat denaturation of egg white is usually followed by polymerization or gelatin of the denatured components, primarily albumin, and is associated with manifestation of a distinct increase in scattering or whitening of the egg white. In this study the effect pulsed laser coagulation of egg white was studied using a CTH:YAG laser delivered through a 600 micrometers diameter fiber into a cuvette filled with raw egg white. The dynamics of laser induced photothermal denaturation of egg white was observed by monitoring the increase of light scattering by time resolved video imaging. Two distinct laser induced processes were observed. At higher radiant exposure (> 30 - 40 J/cm<SUP>2</SUP>) the egg whites was rapidly heated above the water vapor transition temperature and a cavitation bubble was formed. Below threshold for bubble formation a bullet-like zone of whitened egg-white is formed at the top of the fiber.
The effects of 2.12 micrometers Cr:Tm:Ho:YAG laser pulses delivered in isotonic saline solution via an optical fiber system on fresh porcine femur patellar groove cartilage were studied in vitro. Various irradiation geometry, corresponding to angles of 0 - 90 degree(s) of the delivering fiber with respect to the cartilage surface, have been investigated. A laser pulse energies of 1.0 J with a pulse duration of 250 microsecond(s) (FWHM) was used. The dynamics of the induced transient vapor bubbles and the ablation process were monitored by time resolved flash videography techniques. Acoustic transients of up to 200 bars induced by bubble collapses were measured by a calibrated piezoelectric needle probe hydrophone. Histological assessment of the irradiated cartilage samples was performed using azan and Safranin-O stains. The extent of the area of altered cartilage cells is larger than the zone of tissue matrix damage. The predominant mechanism of tissue damage is thermal rather than acousto-mechanical. Cartilage treatment at an angle of incidence of 30 degree(s) reduces significantly the overall damage as compared to 60 degree(s) or 90 degree(s) irradiation.
The ablation of fresh harvested porcine femur patellar groove cartilage by a 2.12 micrometers Cr:Tm:Ho:YAG laser in clinically used irradiation conditions was studied. Laser pulses were delivered via a 600 micrometers diameter fiber in isotonic saline. Ablation was investigated as a function of the angle of incidence of the delivery fiber with respect to the cartilage surface (0-90 degrees) and of radiant exposure. Laser pulses with energies of 0.5, 1.0 and 1.5 J and a duration of 250 microseconds were used. A constant fiber tip-tissue distance of 1 mm was maintained for all experiments. The dynamics of the induced vapor bubble and of the ablation process was monitored by time resolved flash videography with a 1 microseconds illumination. Acoustic transients were measured with a piezoelectric PVDF needle probe hydrophone. Bubble attachment to the cartilage surface during the collapse phase, leading to the direct exposition of the cartilage surface to the maximal pressure generated, was observed in all investigated irradiation conditions. Maximal pressure transients of up to 200 bars (at 1 mm distance from the collapse center) were measured at the bubble collapse at irradiation angles >= 60 degrees. No significant pressure variation was observed in perpendicular irradiation conditions as a function of radiant exposure. A significant reduction of the induced pressure for irradiation angles <EQ 30 degrees was found.
Mechanical injury during pulsed laser ablation of tissue is caused by rapid bubble expansions and collapse or by laser-induced pressure waves. In this study the effect of material elasticity on the ablation process has been investigated. Polyacrylamide tissue phantoms with various water concentrations (75-95%) were made. The Young's moduli of the gels were determined by measuring the stress-strain relationship. An optical fiber (200 or 400 micrometers ) was translated into the clear gel and one pulse of holmium:YAG laser radiation was given. The laser was operated in either the Q-switched mode (tau) <SUB>p</SUB> equals 500 ns, Q<SUB>p</SUB> equals 14 +/- 1 mJ, 200 micrometers fiber, H<SUB>o</SUB> equals 446 mJ/mm<SUP>2</SUP>) or the free-running mode ((tau) <SUB>p</SUB> equals 100 microsecond(s) , Q<SUB>p</SUB> equals 200 +/- 5 mJ, 400 micrometers fiber, H<SUB>o</SUB> equals 1592 mJ/mm<SUP>2</SUP>). Bubble formation inside the gels was recorded using a fast flash photography setup while simultaneously recording pressures with a PVDP needle hydrophone (40 ns risetime) positioned in the gel, approximately 2 mm away from the fibertip. A thermo-elastic expansion wave was measured only during Q-switched pulse delivery. The amplitude of this wave (approximately equals 40 bar at 1 mm from the fiber) did not vary significantly in any of the phantoms investigated. Rapid bubble formation and collapse was observed inside the clear gels. Upon bubble collapse, a pressure transient was emitted; the amplitude of this transient depended strongly on bubble size and geometry. It was found that (1) the bubble was almost spherical for the Q-switched pulse and became more elongated for the free-running pulse, and (2) the maximum bubble size and thus the collapse amplitude decreased with an increase in Young's modulus (from 68 +/- 11 bar at 1 mm in 95% water gel to 25 +/- 10 bar at 1 mm in 75% water gel).
Mechanical injury during pulsed holmium laser ablation of tissue is caused by rapid bubble expansion and collapse or by laser-induced pressure waves. In this study the effect of pulse duration on the photomechanical response of soft tissue during holmium:YAG laser ablation has been investigated. The dynamics of laser-induced bubble formation was documented in water and in transparent polyacrylamide tissue phantoms with a water concentration of 84%. Holmium:YAG laser radiation ((lambda) equals 2.12 micrometers ) was delivered in water or tissue phantoms via an optical fiber (200 or 400 micrometers ). The laser was operated in either the Q- switched mode ((tau) <SUB>p</SUB> equals 500 ns, Q<SUB>p</SUB> equals 14 +/- 1 mJ, 200 micrometers fiber, H<SUB>o</SUB> equals 446 mJ/mm<SUP>2</SUP>) or the free-running mode ((tau) <SUB>p</SUB> equals 100 - 1100 microsecond(s) , Q<SUB>p</SUB> equals 200 +/- 5 mJ, 400 micrometers fiber, H<SUB>o</SUB> equals 1592 mJ/mm<SUP>2</SUP>). Bubble formation was documented using a fast flash photography setup while simultaneously a PVDP needle hydrophone (40 ns risetime), recorded pressures. The effect of the pulse duration on the photomechanical response of soft biological tissue was evaluated by delivering 5 pulses of 800 mJ to the intimal side of porcine aorta in vitro, followed by histologic evaluation. It was observed that, as the pulse duration was increased the bubble shape changed from almost spherical for Q-switched pulses to a more elongated, cylindrical shape for the longer pulse durations. The bubble expansion velocity was larger for shorter pulse durations. A thermo- elastic expansion wave was measured only during Q-switched pulse delivery. All pulses that induced bubble formation generated pressure waves upon collapse of the bubble in water as well as in the gel. The amplitude of the pressure wave depended strongly on the size and geometry of the laser-induced bubble. The important findings of this study were (1) the magnitude of collapse pressure wave decreased as laser pulse duration increased, and (2) mechanical tissue damage is reduced significantly by using longer pulse durations (> 460 microsecond(s) , for the pulse energy used).
The goal of this work was to study the influence of pulse duration on acoustic transient generation in holmium laser ablation. For this, the generation and collapse of cavitation bubbles induced by Q-switched and free-running laser pulses delivered under water were investigated. Polyacrylamide gel of 84% water content served as a model for soft tissue. This gel is a more realistic tissue phantom than water because it mimics not only the optical properties but also the mechanical properties of tissue. The dynamics of bubble formation inside the clear gel were observed by 1 ns time resolved flash videography. A polyvinylidenefluoride (PVDF) needle probe transducer measured absolute values of pressure amplitudes. Pressure wave generation by cavitation bubble collapse was observed in all phantoms used. Maximum pressures of more than 180 bars at 1 mm from the collapse center were observed in water and high water-contents gels with a pulse energy of 200 mJ and a 400 micrometers fiber. A strong dependency of the bubble collapse pressure on the pulse duration for constant pulse energy was observed in gel as well as in water. For pulse durations longer than 400 microsecond(s) a 90% reduction of pressure amplitudes relative to 100 microsecond(s) pulses was found. This suggests that optimization of pulse duration offers a degree of freedom allowing us to minimize the risk of acoustical damage in medical applications like arthroscopy and angioplasty.
Erbium and Holmium lasers are ideally suited for cutting and drilling biological tissue. This is due to the fact that their wavelengths (Er:YSGG at 2.79 micrometers and Ho:YAG at 2.12 micrometers ) are strongly absorbed in water which is present in all tissues. Combined with an optical fiber these lasers seem to be optimal instruments for endoscopic and/or minimal invasive applications in surgery. In this study we focused our interest on cutting of human meniscus in the knee where, besides a very limited operation field, the standard arthroscopic treatment is performed in a liquid, highly absorbing environment. The bubble formation process, therefore, has to be well understood because it mainly determines relevant aspects of tissue ablation. The influence of the laser parameters in general and the influence of pulse duration in particular are determined in this paper for two different laser wavelengths. The goal was to determine the optimum laser parameters in view of a high ablation efficiency, a high precision and a minimal destruction of the adjacent tissue. To determine the optimum pulse duration for ablating tissue under water and to obtain a better understanding of the channel formation process, transmission and pressure measurements together with video flash photography were performed. Additionally, we determined experimentally the ratio between initial laser pulse energy and energy available for tissue treatment under water. To prove the results obtained, cuts in human meniscus were performed, sectioned and evaluated. The comparison between the results obtained with the Erbium and Holmium laser revealed a strong influence of the absorption coefficients on the tissue effects, especially on the ablation efficiency and on the zone of thermally and mechanically damaged tissue.
The intense interest in the investigation of erbium laser radiation in medicine is due to the fact that radiation at 3 micrometers is very strongly absorbed by water, which is present in all biological tissue. As a consequence of this high absorption the interaction of pulsed radiation is characterized by an explosive process with a low ablation threshold and a thin coagulation zone along the laser incisions. Erbium lasers, therefore, have a wide field of potential medical applications which become even more attractive with the availability of reliable delivery systems. An interesting situation arises in orthopaedics and angioplasty, where a precise cutting instrument is needed in a liquid environment. For this reason, we experimentally investigated the interaction mechanism of fiber transmitted, pulsed, free-running and Q- switched Erbium:YSGG ((lambda) equals 2.79 micrometers ) and Erbium:YAG ((lambda) equals 2.94 micrometers ) laser radiation with liquid water. The dynamics of the bubble formation and the propagation of shockwaves in water was studied and visualized by flash photography. Acoustic transients of a few hundreds of bars accompanying the ablation process were measured with a needle hydrophone. A clear correlation between the spikes of the laser pulse and those of the pressure signal was observed. Additionally, strong pressure transients were measured after the end of the laser pulse, which could be associated with the collapse of the vapor bubble and further collapses after multiple rebounds. The influence of pulse energy, fiber size and pulse duration on the formation and the amplitude of the pressure waves is demonstrated.
In this study the role of acoustical transients during pulsed holmium laser ablation is addressed. For this the collapse of cavitation bubbles generated by 2.12 micrometers Cr:Tm:Ho:YAG laser pulses delivered via a fiber in water is investigated. Multiple consecutive collapses of a single bubble generating acoustic transients are documented. Pulse durations are varied from 130 - 230 microsecond(s) and pulse energies from 20 - 800 mJ. Fiber diameters of 400 and 600 micrometers are used. The bubble collapse behavior is observed by time resolved fast flash photography with 1 microsecond(s) strobe lamp or 5 ns 1064 nm Nd:YAG laser illumination. A PVDF needle probe transducer is used to observe acoustic transients and measure their pressure amplitudes. Under certain conditions, at the end of the collapse phase the bubbles emit spherical acoustic transients of up to several hundred bars amplitude. After the first collapse up to two rebounds leading to further acoustic transient emissions are observed. Bubbles generated near a solid surface under water are attracted towards the surface during their development. The final phase of the collapse generating the acoustic transients takes place directly on the surface, exposing it to maximum pressure amplitudes. Our results indicate a possible mechanism of unwanted tissue damage during holmium laser application in a liquid environment as in arthroscopy or angioplasty that may set limits to the choice of laser pulse duration and energies.