TY - JOUR
T1 - Pulsed Laser-induced Liquid Jet System for Treatment of Sellar and Parasellar Tumors
T2 - Safety Evaluation
AU - Nakagawa, Atsuhiro
AU - Ogawa, Yoshikazu
AU - Amano, Kosaku
AU - Ishii, Yudo
AU - Tahara, Shigeshi
AU - Horiguchi, Kentaro
AU - Kawamata, Takakazu
AU - Yano, Shigetoshi
AU - Arafune, Tatsuhiko
AU - Washio, Toshikatsu
AU - Kuratsu, Jun Ichi
AU - Saeki, Naokatsu
AU - Okada, Yoshikazu
AU - Teramoto, Akira
AU - Tominaga, Teiji
PY - 2015/1/16
Y1 - 2015/1/16
N2 - 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.
AB - 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.
KW - functional preservation
KW - maximal lesion removal
KW - medical engineering
KW - minimally invasive surgery
KW - water jet
UR - http://www.scopus.com/inward/record.url?scp=84944410748&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84944410748&partnerID=8YFLogxK
U2 - 10.1055/s-0034-1396436
DO - 10.1055/s-0034-1396436
M3 - Article
C2 - 25594817
AN - SCOPUS:84944410748
VL - 76
SP - 473
EP - 482
JO - Journal of Neurological Surgery, Part A: Central European Neurosurgery
JF - Journal of Neurological Surgery, Part A: Central European Neurosurgery
SN - 2193-6315
IS - 6
ER -