Neurosurgical Laser Improves Removal of Complex Tumors

A new micro-laser offers surgeons greater precision and efficiency, reducing the incision size, surgery time, and patient recovery period following neurosurgery.

The BeamPath Neuro laser was designed for operation near critical structures in the brain and spine and is used in place of a scalpel to cut tissue and remove tumors, since carbon dioxide (CO2) laser energy generates a minimal thermal spread, which makes it useful for applications near critical anatomical structures. The CO2 laser also has a superficial action limited to the upper layers of tissue when compared with other energy sources, causing minimal damage to adjoining tissue volume. In addition, CO2 laser energy seals small blood vessels as it cuts through the tissue, thus combining precise cutting, ablation, and microvascular coagulation.

The flexibility of the BeamPath Neuro laser allows surgeons to direct CO2 laser energy into deep cavities and around blood vessels and other specific nerve structures, including the brainstem, by utilizing an innovative photonic band gap mirror lining, which guides light through a hollow core. The photonic bandgap fibers serve as solid-state structure-based transmitters; within each fiber, over forty microscopic alternating layers of glass and polymer form a reflective system known as a Bragg diffraction grating. The wavelength of light transmitted by this structure is a function of the thickness of the glass and polymer bi-layers, which can be easily varied. Thus, the BeamPath fibers can be scaled to channel different wavelengths of light. The BeamPath Neuro laser is a product of OmniGuide (Cambridge, MA, USA).

"The laser enables us to be much more efficient during surgery; we are able to remove tumors much more quickly, which shortens overall surgery time,” said Andrew Fishman, M.D., a neurootologist and skull base surgeon at Northwestern Memorial Hospital (Chicago, IL, USA). "That translates into a quicker recovery for patients.”

Among surgical cutting tools, CO2 lasers offer more precision and control over penetration depth into tissue. However, the long wavelength of CO2 laser energy (10.6 microns) effectively limited these lasers strictly to "line-of-sight” surgical procedures, and prevented the development of a flexible fiber delivery system. The development of the bandgap fibers offered a new paradigm in the field of light transmission, resolving the limitations inherent in conventional fiber optics.

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