THE OPTIMIZATION OF LASER PROSTATECTOMY .2. OTHER LASING TECHNIQUES

Objectives. To evaluate the laser-tissue interaction during neodymium:yttrium-aluminum-garnet (Nd:VAC) irradiation using right angle firing fibers in motion, contact vaporization applicators, and interstitial lightguides. Methods. The heating patterns and coagulation volumes created during right angle firing fiber pulling and painting, contact tip vaporization, and interstitial thermotherapy were studied in potato and canine models. Results. High power density right angle firing fibers can be used in motion to create coagulation lesions at 40 and 60 watts (W). The depth of such lesions was less than that obtained during fixed free beam side fire coagulation. Contact vaporization applicators caused tissue vaporization without creating concurrent coagulation lesions. Interstitial lightguide thermotherapy created coagulation lesions without carbonization using A step power reduction approach during irradiation. Conclusions. Each of the investigated methods had the ability to destroy prostate tissue, and therefore may have a role in the evolution of laser prostatectomy.