Laser ablation in biliary tree: analysis of the intraductal and superficial thermal effects during the treatment.
Fiche publication
Date publication
juillet 2019
Journal
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference
Auteurs
Membres identifiés du Cancéropôle Est :
Pr MARESCAUX Jacques
Tous les auteurs :
Saccomandi P, Marescaux J, Di Matteo FM, Quero G, Gassino R, Lapergola A, Barberio M, Schena E, Perrone G, Vallan A, Costamagna G
Lien Pubmed
Résumé
The treatment of choice for the unresectable cholangiocarcinoma is based on biliary decompression procedures. Despite stent placement is the standard of care, it is related to well-known complications. Hence, alternative techniques were proposed. Ideally, they should guarantee an adequate intraductal disobstruction, without injuring the surrounding tissues.This pre-clinical study aims to investigate the thermal effects of the laser ablation (LA) in the biliary tree, in terms of intraductal and surrounding tissue temperature achieved with different laser settings. The common bile ducts (in their upper and lower portions) of two pigs were ablated for 6 minutes with a diode laser at 3 W and 5 W. A custom-made laser applicator was used to obtain a circumferential ablation within the ducts. The intraductal temperature (T) was monitored by means of a fiber Bragg grating (FBG) sensor, while an infrared thermal camera monitored the T distribution in the surrounding tissues (T). A maximum T difference of 65 °C and 57 °C was evidenced between the two power settings for the T measured in the upper and lower ducts, respectively. The mean difference between T and the averaged T values was evaluated. At 5 W, a difference of 37±3 °C and 44±10 °C were obtained for the upper and lower ducts, respectively. At 3 W, a T difference of 2±1 °C was obtained for the upper biliary duct, while a difference of 8±1 °C was documented for the lower duct. Based on the results obtained in this preliminary study, the possibility to equip the laser probe with temperature sensor can improve the control and the safety of the procedure; this solution will guarantee the monitoring of the treatment while preserving the lumen and the surrounding structures.
Référence
Conf Proc IEEE Eng Med Biol Soc. 2019 Jul;2019:162-165