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Endoscopic free electron laser technique development for minimally invasive optic nerve sheath fenestration
Author(s) -
Shah Rohan J.,
Shen Jin H.,
Joos Karen M.
Publication year - 2007
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.20531
Subject(s) - insufflation , forceps , medicine , endoscope , endoscopy , optic nerve , surgery , orbit (dynamics) , nuclear medicine , anatomy , engineering , aerospace engineering
Purpose This study proposed to develop a technique for efficiently accessing the posterior orbital space using endoscopy and attempted application of free electron laser (FEL) energy, biopsy forceps, electrocautery, and CO 2 insufflation to posterior orbital tissues. Methods Through an inferior transconjunctival incision, access to the posterior orbital space was attempted in 14 eyes of 7 non‐survival pigs. FEL energy (6.1 µm, 30 Hz, delivered via 250 µm hollow‐glass waveguide), biopsy forceps, and monopolar electrocautery application were endoscopically attempted in the posterior orbit. CO 2 gas insufflation effects were assessed by analyzing arterial blood gases at 30‐minute intervals for 1.5 hours. Results The posterior orbit was accessed in 13 of 14 eyes, the optic nerve was encountered, and FEL energy was applied in 8 of 14 eyes. Use of biopsy forceps and electrocautery were successful. Although ANOVA results for arterial blood gas changes were not statistically significant, visibility was adequate without CO 2 insufflation. Conclusions The posterior orbit was endoscopically accessed and the optic nerve was exposed and successfully treated with FEL energy. CO 2 insufflation did not alter blood gases, but did not further enhance visibility in this study. Lesers Surg. Med. 39:589–596, 2007. © 2007 Wiley‐Liss, Inc.