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Thoracic surgery
On the lungs, the eraser is the gold standard in metastasis surgery. It allows unmatched tissue-saving, gentle and cost-effective as well as complete removal of central and multiple tumours.
The so-called precision resection is preferably carried out with a sterile laser fibre in contact with the tissue at a distance of a couple of millimetres from the tumour edge. The use of a laser fibre instead of a lens hand piece and the high output rating of the laser minimise the heat exposure of the lungs and guarantee a well assessable resectate. The fibre is thereby guided like a scalpel and facilitates thanks to the direct contact with the tissue the cutting procedure in comparison with a lens hand piece. The heat occurring counteracts a tumour cell spread.
Thanks to this technique, a large number of metastases can be removed from the lung without losing hardly any healthy tissue and even previously inoperable patients in terms of technology can be treated in a cost-effective manner.
In addition to metastasis surgery, benefits also arise in other parenchyma resections on the lungs, such as segment resections. Here, an anatomical resection can be carried out with the laser that is not negatively affected by the rigid geometry of an instrument such as when bracket stitch devices are used.
See H.C. Dienemann et. al. (eds.), Chest Surgery, Springer Surgery Atlas Series, DOI 10.1007/978-3-642-12044-2_13, Springer Verlag Berlin Heidelberg 2015
Surival rates after complete resection of metastases of 415 patients; source: Prof. Dr. med. Axel Rolle
Survival rates of patients with different numbers metastases after complete removal by eraser laser (1 metastasis = 99 patients, 2-9 metastases = 216 patients, 10 metastases an more = 100 patients) ; Quelle: Prof. Dr. med. Axel Rolle
Urology
The eraser is predominantly used in urology for minimally invasive procedures. This type of treatment is becoming increasingly common thanks to the lower death rates compared to conventional surgery methods, but makes greater demands on the instruments especially as regards blood coagulation compared to conventional surgery methods.
The eraser offers precisely this benefit: thanks to the use of flexible laser fibres it can be integrated in nearly any mini-mally invasive instrument and offers blood coagulation that outperforms that of other instruments thanks to its wave length.
When used for enucleation of the prostate, the eraser comes with huge benefits:
- Independence from the size of the prostate to be removed,
- outstanding blood coagulation capacity, which means that patients under anticoagulation can also be treated,
- continuous release of laser light, therefore easier cutting,
Due to the superior blood coagulation, very good layer with the final model procedure of the prostate sectate.
See Lukas Lusuardi, et. al.: Safety and Efficacy of Eraser Laser Enucleation of the Prostate: Preliminary Report; THE JOURNAL OF UROLOGY¸ Vol. 186, 1967-1971, November 2011
In addition, the eraser is also used very successfully for the removal of kidney tumours both in open surgery and in a minimally invasive manner. Here, blood coagulation is the key demand for the laser. At the same time, the tumours need to be removed in a careful manner and such that a minimal amount of healthy tissue is lost. Thanks to the very good blood coagulation of the eraser, these resections can be carried out with low blood losses, where applicable the ischemia period reduced and partly no ischemia is needed at all, which in turn supports the post-surgery function of the kidney .
See Wael Y. Khoder, Ronald Sroka, et. al.: The 1,318-nm diode laser supported partial nephrectomy in laparoscopic and open surgery: preliminary results of a prospective feasibility study ; Lasers Med Sci DOl 10.1007/s10103-011-0897y
Movie shows parts of a prostate enucleation by eraser laser system at 100 Watt of power output.
Easily recognizable the advantages of the eraser:
- excellent hemostasis,
- due to superior sight during surgery and afterwards during morcellation procedure.
Resection of a kidney tumor by eraser laser. Due to excellent hemostasis of the special wave length, the time of ischemia was reduced from 20 to 9 minutes.
Click in the image for zoom and move mouse to move image.
Visceral surgery
The eraser is also successfully used on the liver to remove metastases and during liver separation resections.
It enables a quick and safe cutting in particular in the parenchyma areas of the liver.
Pneumology
In pneumology, the eraser is used to remove tumours that block the respiratory tracts. Here, it offers significant benefits compared to the common argon beamer as regards speed and blood coagulation.
Resection of a tumor that penetrated the bronchial wall by eraser laser.
Advantages of the erasr laser compared to the Argon beamer:
- works on hard tumors,
- superior hemostasis.