Composite-Type Optical Fiberscope for Laser Surgery for Twin-to-Twin Transfusion Syndrome

Authors:
Kiyoshi Oka;Akihiro Naganawa;Hiromasa Yamashita;Tetsuya Nakamura;Toshio Chiba
Affiliations:
Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki, Japan;Akita University, Akita, Japan;National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan;PENTAX Corporation, Saitama, Japan;National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
Venue:
MIAR '08 Proceedings of the 4th international workshop on Medical Imaging and Augmented Reality
Year:
2008

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A Coaxial Laser Endoscope with Arbitrary Spots in Endoscopic View for Fetal Surgery

MICCAI '09 Proceedings of the 12th International Conference on Medical Image Computing and Computer-Assisted Intervention: Part I

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Abstract

We present our new laser device for prospective human fetoplacental surgery including that of twin-twin transfusion syndrome. We developed a composite-type optical fiberscope (2.2-mm in diameter) that enables transmission of 40-W Yb fiber laser light alongside of coaxial fetoscopic images. Using a laser condensing lens on the fiberscope tip, Yb fiber laser light can be focused 10-mm off. Using porcine liver tissue, despite changes in delivered laser energy, the diameter and depth of cauterized areas remained constant when the liver position agreed with the laser focal point, although the laser output altered the extent of tissue ablation. In conclusion, the performance of the fiberscope can be well controlled with accurate and efficient ablation of the target tissue. This Yb fiber laser fiberscope is expected to work much better if mounted on a miniature bending manipulator and if provided with additional functions (real-time distance and blood flow measurements).