In this paper we describe optical and dynamic performance of tip/tilt micromachined mirrors fabricated using the SUMMIT V surface micromachining process. We find that the tilt angle for a given mirror design is determined by a combination of geometric factors and stiffness of the capacitive suspension. Switching speeds of ~40-50 microsecond(s) econds are measured for 50 micrometers -square mirrors. Finally surface roughness and curvature before and after metallization are obtained using white light interferometry.
Numerical simulations are presented of the laser-tissue interaction of a diode laser system for treating benign prostate hyperplasia. The numerical model includes laser light transport, heat transport, cooling due to blood perfusion, thermal tissue damage, and enthalpy of tissue damage. Comparisons of the stimulation results to clinical data are given. We report that a reasonable variation from a standard set of input data produces heating times which match those measured in the clinical trials. A general trend of decreasing damage volume with increasing heating time is described. We suggest that the patient-to-patient variability seen in the data can be explained by differences in fundamental biophysical properties such as the optical coefficients. Further work is identified, including the measurement and input to the model of several specific data parameters such as optical coefficients, blood perfusion cooling rate, and coagulation rates.
The generation of vapor-driven bubbles is common in many emerging laser-medical therapies involving soft tissues. To successfully apply such bubbles to processes such as tissue break-up and removal, it is critical to understand their physical characteristics. To complement previous experimental and computational studies, an analytic mathematical model for bubble creation and evolution is presented. In this model, the bubble is assumed to be spherically symmetric, and the laser pulse length is taken to be either very short or very long compared to the bubble expansion timescale. The model is based on the Rayleigh cavitation bubble model. In this description, the exterior medium is assumed to be an infinite incompressible fluid, while the bubble interior consists of a mixed liquid-gas medium which is initially heated by the laser. The heated interior provides the driving pressure which expands the bubble. The interior region is assumed to be adiabatic and is described by the standard water equation-of- state, available in either tabular, or analytic forms. Specifically, we use adiabats from the equation-of-state to describe the evolution of the interior pressure with bubble volume. Analytic scaling laws are presented for the maximum size and duration of bubbles as functions of the laser energy and initially heated volume.
Many novel treatments for BPH are predicated on depositing power, for example using a laser, microwave, or rf source, to generate heat. In order to be useful and effective a requisite amount of power must be deposited in the tissue so that a reasonable amount of tissue can be necrosed in a reasonable time. The potential to be effective is fundamentally effected by the electromagnetic frequency. The frequency of the power source dictates the penetration characteristic in tissue, and thus the size of the heat source that can subsequently conduct further into the tissue. Because tissue char limits the peak temperature accessible for any power source, a particular frequency can only effectively heat a certain amount of tissue, given similar conditions. Too large a penetration of power can be as ineffective as too shallow.
Benign prostatic hyperplasia (BPH) can significantly impair quality of life in older men. Most men over 60 experience some symptoms due to BPH and it is thought that essentially all men would eventually be affected by it if they lived long enough. At present, transurethral resection of the prostate (TURP), a surgical treatment for BPH, is one of the more common procedures performed in the developed world, particularly in the United States. A number of other treatments are also often used, including open prostatectomy, side-firing lasers, and drug therapy. With the population in the developed world rapidly aging, BPH is expected to affect an even larger group of men in the future. Current methods of therapy carry significant disadvantages. Open prostatectomy carries a fairly high risk of impotence and incontinence, as well as sometimes significant risk of death depending on the patient's age and medical conditions. TURP also carries similar risks, albeit reduced, including the risk of substantial blood loss and a small but meaningful risk of death. Side-firing lasers are thought to have a reduced risk of death compared to TURP due to significantly reduced bleeding; however, patients often experience an extended period of pain during voiding due to prolonged tissue sloughing. Drug treatment, although useful for some patients, does not strongly improve symptoms in the majority of patients. Even with the current range of treatments, many patients with symptomatic BPH elect to avoid any current treatment due to risks and side effects. As a possible solution to this problem, previous writers have suggested the possibility of treating BPH through interstitial thermotherapy. In this treatment, prostatic tissue is heated from within the prostate to the point of irreversible necrosis. Healing processes then reduce the volume of the affected tissue, even in the absence of sloughing. This study covers initial human use of such a device, using an 810 nm wavelength diode laser not previously used for such therapy.
Diode lasers are air-cooled, efficient, compact devices which have the potential of very low cost when produced in quantity. The characteristics of diode lasers are discussed. Their applications in interstitial thermal treatment of the prostate, and laser ablation of prostate tissues, will be presented.
As a possible solution to this problem, previous writers have suggested the possibility of treating BPH through interstitial thermotherapy. In this treatment, prostatic tissue is heated from within the prostate to the point of irreversible necrosis. Healing processes then reduce the volume of the affected tissue, even in the absence of sloughing. This study covers initial human use of such a device, using an 810 nm wavelength diode laser not previously used for such therapy.