Diagnostic and therapeutic laser applications in pulmonary medicine – A review

Laser-Material Interactions for Flexible Applications

The use of lasers for industrial, scientific, and medical applications has received an enormous amount of attention due to the advantageous ability of precise parameter control for heat transfer. Laser-beam-induced photothermal heating and reactions can modify nanomaterials such as nanoparticles, nanowires, and two-dimensional materials including graphene, in a controlled manner. There have been numerous efforts to incorporate lasers into advanced electronic processing, especially for inorganic-based flexible electronics. In order to resolve temperature issues with plastic substrates, laser-material processing has been adopted for various applications in flexible electronics including energy devices, processors, displays, and other peripheral electronic components. Here, recent advances in laser-material interactions for inorganic-based flexible applications with regard to both materials and processes are presented.

Endobronchial therapy with a thulium fiber laser (1940 nm)

BACKGROUND

Nd:YAG laser (1064 nm) is standard in bronchology. The thulium fiber laser (1940 nm) has a nearly 1000-fold increased absorption in water, enabling precise tissue ablation with a small margin of coagulation, whereas 1064-nm laser light penetrates deeper into tissue with less controllable effects.

OBJECTIVES

To assess the safety, feasibility, and versatility of endobronchial thulium laser therapy in an observational cohort study.

METHODS

Endobronchial treatment with the thulium fiber laser was performed in a cohort study of 187 bronchoscopies on 132 consecutive patients with 135 endobronchial lesions amenable to laser resection.

RESULTS

The thulium fiber laser produced superficial, precise, and rapid tissue ablation. Eighty-one lesions were completely vaporized; 82 lesions were treated by deep tissue destruction by inserting the fiber into tissue followed by mechanical resection. Tumor bleeding was coagulated with rapid and sustained hemostasis (n = 28). Nitinol stents were removed after resection of severe granulation tissue overgrowth (n = 10). Intact stents were maintained after ablation of in-stent tissue (n = 47). In 11 cases, bleeding occurred during laser treatment (n = 11 of 187). Power settings between 5 and 20 W were found to be safe.

CONCLUSIONS

Endobronchial therapy with the thulium laser at 1940 nm seems to be safe, feasible, and highly versatile for treatment of airway stenosis and stent obstruction caused by tissue ingrowth. Further studies are warranted.