Influence of irrigation on incision and coagulation of 2.0-μm continuous-wave laser: an ex vivo study.

Background: Several lasers are suitable for laparoscopic surgery but with remarkable smoke formation, which compromises surgical visibility and safety. Slow irrigation eliminates laser smoke efficiently, but gives rise to the concern of reducing the laser incision and coagulation efficiency.

Methods: Canine kidney specimens were manually cut with a 2-μm continuous-wave Thulium-YAG laser. Two laser powers (20 and 40 W) combined with 3 irrigation rates (0, 20, and 80 mL/min) were experimented. The depth of the cutting slot and the thickness of the coagulation layer were measured microscopically and compared statistically between different setting combinations using 2-way analysis of variance.

Results: The incision depth was decreased significantly at high (80 mL/min) but not low rate (20 mL/min). The thickness of the coagulation layer changed insignificantly with the irrigation rate.

Conclusions: Slow irrigation had an acceptable influence on the incision and the coagulation ability of 2.0-μm continuous-wave laser and is suitable and efficient to address the smoke issue in laser laparoscopic surgery.