Miniature Laser System Could Accurately Distinguish Tumors from Healthy Tissue

The integration of lasers into ophthalmology since the early 1990s marked a significant technological advancement, and since then, laser technology has expanded its reach into other medical fields. The use of lasers in surgery offers numerous benefits over traditional tools like scalpels and saws. However, their adoption has been limited to specific applications, partly due to concerns about potential injury to adjacent tissues and the challenge of controlling the cutting depth that could accidentally damage the deeper layers of tissue. Despite these challenges, laser technology continues to evolve, becoming more sophisticated and precise. Now, new research could significantly enhance the safe and effective use of lasers in surgical procedures.

A research team from the University of Basel (Basel, Switzerland) has made a notable breakthrough by creating a laser system that combines three critical functionalities: bone cutting, cutting depth control, and tissue differentiation. This multifunctional system employs three lasers, all focused on a single point. The first laser functions as a tissue sensor, scanning the area around the bone-cutting site. It emits regular pulses, vaporizing tiny tissue samples, whose composition is then analyzed by a spectrometer. Each tissue type emits a distinct spectrum, allowing the creation of a detailed map distinguishing bone from soft tissue. Only after this mapping process does the second laser, designed for bone cutting, activate, targeting areas identified as bone on the generated map. Concurrently, the third laser, an optical system, monitors the depth of the cut, ensuring it doesn’t exceed the intended level.

Throughout the procedure, the tissue sensor continuously verifies that the correct tissue is being cut. This self-regulating system operates autonomously, without human intervention. The team has conducted tests on pig femur bones and tissues, demonstrating the system’s precision down to minute fractions of a millimeter. The speed of this laser system is also comparable to conventional surgical methods. Current efforts are focused on reducing the system's size. The researchers have successfully condensed the optical and cutting lasers into a matchbox-sized unit. The next step is to incorporate the tissue sensor and further miniaturize the entire setup, ultimately fitting it into an endoscope for minimally invasive surgeries. This advanced system has potential applications across various surgical fields. It could, for instance, enable surgeons to more accurately differentiate and excise tumors from healthy tissue, minimizing the removal of uninvolved surrounding tissue. Additionally, the controlled laser cutting allows for innovative cut shapes, which could enhance the integration of bone implants with existing bone structures.

“Making more use of lasers in surgery is a worthy ambition for a number of reasons,” said Dr. Arsham Hamidi, lead author of the study. Contact-free cutting somewhat reduces the risk of infections, he points out. “Smaller and more precise incisions also mean that the tissue heals more rapidly, and that scarring is reduced.”

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