By Thomas A. Angerpointner (auth.), Priv.-Doz. Dr. Thomas A. Angerpointner (eds.)
In traditional partial resection of parenchymatous organs major bleeding is likely one of the major difficulties, specially in neonates and babies. The sufferers quickly lose enormous quantities in their small blood quantity. Laser gentle results in photograph thermal results in tissue and reasons coagulation, drying up, carbonization and evaporization, looking on the temperature. The neodymium Y AG laser emits nonvisible gentle within the close to infrared with a wavelength of l. 0611m. This wavelength implies a comparatively deep penetration into the tissue. This laser approach, competently a coagulation laser, achieves its slicing impact via its excessive energy density . as a result of thermal radiation in all instructions, each side of the part airplane are coagulated as a favorable aspect influence. hence, in parenchymatous organs a mixture of resection and sealing of the minimize vessels and ducts, as much as a constrained diameter, is acquired. Laser tools We use a neodymium-YAG laser mediLas 2 (MBB-Medizintechnik, D-8012 Ottobrunn, Federal Republic of Germany), wavelength l. 0611m, maximal strength output round a hundred and ten W (Fig. 1). generally we like to paintings with out tissue touch, Fig. l. The Nd-YAG laser procedure mediLas 2 with maximal energy output round a hundred W The Neodymium Y AG Laser in surgical procedure of Parenchymatous Organs 25 Fig. 2. The focusing handpiece with focal distance of fifty mm 1cm Fig. 3.
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Extra info for Operative Technique in Neonates and Infants
The surface is covered by coagulated material. Tissue on the right-hand side of the picture shows degenerated and destroyed hepatocytes. In the middle there are slight cystic changes with granulocytes, erythrocytes and fibrin. Histologically normal hepatocytes appear to the left at a depth of approximately 1 mm. H & E, x 90 fixed in 10% formalin, processed according to standard routine, embedded in paraffin and stained by haematoxylin-eosin and van Gieson stain. Resection of liver from pigs (Fig.
The main benefits of infrared contact coagulation are cheapness, easy handling, very rapid haemostasis in wet tissue, large area of the coagulation head and deep coagulation of parenchymatous tissue up to 5 mm. Infrared contact coagulation is a valuable method for preservation of injured parenchymatous organs in paediatric surgery. References 1. Angerpointner TA, Lauterjung KL, Holschneider AM, Hecker WC (1983) Infrared contact coagulation of parenchymatous organs - report of three cases. Z Kinderchir 38:356-358 2.
II a un effet conservateur lors du traitement chirurgical d'un organe blesse. Pediatric Surgical Clinic, Dr. von Hauners Childrens Hospital, University of Munich, Lindwurmstrasse 4, D-8000 Munich 2, Federal Republic of Germany Progress in Pediatric Surgery, Vol. ) © Springer-Verlag Berlin H eidelberg 1990 24 P. P. Schmittenbecher Introduction In conventional partial resection of parenchymatous organs significant bleeding is one of the main problems, especially in neonates and infants. The patients rapidly lose considerable amounts of their small blood volume.
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