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Evaluation of Carbon Dioxide Laser Surgical Unit in Neurosurgery

1979; Japan Neurological Society; Volume: 19; Issue: 9 Linguagem: Inglês

10.2176/nmc.19.881

1349-8029

Toshiteru Ohnishi, Toshiki Yoshimine, Tōru Hayakawa, Kiyoo KAMIKAWA,

Meningioma and schwannoma management

“Medilaser-S Model MEL-442” is a CO2 laser surgical unit manufactured by Mochida Pharmaceutical Co. Ltd.. The maximum output power is 60 W at the handpiece of the surgical arm. Scalp incision, dural incision and corticotomy were performed by laser surgery and the results of laser surgery were compared with those of conventional neurosurgical techniques in the same materials. Blood loss during scalp incision was reduced by laser surgery. However, wound healing of the scalp was delayed with slightly extended scar formation. Laser surgery was not necessary for dural incision. At corticotomy by laser surgery, the large vessels had to be clipped or coagulated electrically when it was hard to cut them by laser alone. It was concluded that no need of laser surgery was recognized for craniotomy and corticotomy. Coagulation and vaporization by laser irradiation to the brain tumors resulted in reduction of blood loss during surgery and time saving of the procedures. When the tumors were large and the vessels were abundant in the tissue, the laser surgical unit proved to be a powerful surgical asset. Six cases of meningiomas, 4 cases of glioblastomas and 7 cases of metastatic brain tumors were successfully removed by the aid of the laser surgical unit. Three cases of arteriovenous malformations in the brain were also treated by laser. Defocused beam irradiation caused coagulation of the nidus of AVM, but the large vessels were not coagulated. Coagulation of the nidus helped surgeons to clip the feeders and the drainers without any trouble. Combination of the surgical microscope and the laser surgical unit was useful for transsphenoidal operation of a pituitary tumor.