Pulsed Laser-induced Liquid Jet System for Treatment of Sellar and Parasellar Tumors: Safety Evaluation

Atsuhiro Nakagawa, Yoshikazu Ogawa, Kosaku Amano, Yudo Ishii, Shigeshi Tahara, Kentaro Horiguchi, Takakazu Kawamata, Shigetoshi Yano, Tatsuhiko Arafune, Toshikatsu Washio, Jun Ichi Kuratsu, Naokatsu Saeki, Yoshikazu Okada, Akira Teramoto, Teiji Tominaga

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

ObjectiveThe pulsed laser-induced liquid jet (LILJ) system is an emerging surgical instrument intended to assist both maximal removal of the lesion and functional maintenance through preservation of fine vessels and minimal damage to the surrounding tissue. The system ejects the minimum required amount of pulsed water through a handy bayonet-shaped catheter. We have already shown a significant increase in removal rate, in addition to a noteworthy reduction of intraoperative blood loss and procedure time in the treatment of large pituitary and skull base tumors in a single-institution series. The present study evaluated the safety of the system in multiple institutions. MethodsThe study included 46 patients, 29 men and 17 women (mean age: 59.1 years) who underwent microsurgical/endoscopic resection of lesions in or in the vicinity of the pituitary fossa through the transsphenoidal approach between October 2011 and June 2012 at six institutions. The histologic diagnoses were pituitary adenoma (31 cases), meningioma (4), craniopharyngioma (3), cavernous angioma (2), and Rathke cyst cleft (1). Lesion volume ranged from 2.0 to 30.4 cm3 (mean: 3.7 cm3). Cavernous sinus invasion was observed in 11 cases and suprasellar extension in 29 cases. ResultsPreservation of intralesional arteries (diameter: 150 μm) was achieved in all situations in>80% of cases. Intended surgical steps were achieved except for some restrictions in motion due to the use of an optical quartz fiber. No complications occurred directly related to the use of the device. ConclusionsThe LILJ system can be used for safe removal of lesions in or in the vicinity of the pituitary fossa.

Original languageEnglish
Pages (from-to)473-482
Number of pages10
JournalJournal of Neurological Surgery, Part A: Central European Neurosurgery
Volume76
Issue number6
DOIs
Publication statusPublished - 2015 Jan 16

Keywords

  • functional preservation
  • maximal lesion removal
  • medical engineering
  • minimally invasive surgery
  • water jet

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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