Motivation for the study
Surgical mesh is used to treat female stress urinary incontinence (SUI) and transvaginal pelvic organ prolapse (POP). However, erosion of this synthetic, non-absorbable mesh is a common complication and in more than half of these cases, a surgical excision of the mesh in the operating room is required. The mesh removal is technically challenging, may damage healthy adjacent tissues, and in some cases must be repeated several times. This study aims to explore the feasibility of selective laser vaporization, which could provide safer and improved method for mesh removal. This method is based on selective photothermolysis where target is destroyed through preferential absorption of pulsed laser radiation.
Laser vaporization setup
A compact 7 Watt Modulight laser device at 647 nm was selected for irradiation because absorption by water, hemoglobin, and other tissue chromophores is low at this wavelength while polypropylene absorption is high. This allows for selective laser targeting and vaporization of the mesh. A silica fiber optic patch-cord was used to deliver the laser irradiation from the laser to a lens collimating system, which provided 0.95 µm-diameter laser spot on the surface of sample. A single laser pulse of 100 ms duration was delivered to the tissue, suture, and mesh in the experiments. A camera is included for magnification and alignment of the laser beam with the target, while a separate thermal camera records the temperature of the laser-irradiated target during the testing.
Both suture and mesh were successfully vaporized at the point of irradiation with a single laser pulse. Peak temperature was 180 ⁰C for suture and 232 ⁰C for mesh during the irradiation. Both temperatures are well above the melting temperature of 160-170 ⁰C for these materials. In contrast, temperature of tissue increased only by 1 ⁰C due to low absorption of this wavelength by tissue chromophores.
Photo and graph from the original publication, reproduced with permission from the contact author of the publication.
Related Modulight products and Services
Selective laser vaporization of polypropylene mesh used in treatment of female stress urinary incontinence and pelvic organ prolapse: preliminary studies using a red diode laser
David Burks, Sarah B. Rosenbury, Michael J. Kennelly, Nathaniel M. Fried
Lasers Surg Med, 2012, 44 (4)
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