Studies in fiber guided excimer laser surgery for cutting and drilling bone and meniscus

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Abstract
Our experiments on transmitting high‐power excimer laser pulses through optical fibers and our investigations on excimer laser ablation of hard tissue show the feasibility of using the excimer laser as an additional instrument in general and accident surgery involving minimal invasive surgery. By combining XeCl‐excimer lasers and tapered fused silica fibers we obtained output fluences up to 32 J/cm2 and ablation rates of 3 μm/pulse of hard tissue. This enables us to cut bone and cartilage in a period of time which is suitable for clinical operations. Various experiments were carried out on cadavers in order to optimize the parameters of the excimer laser and fibers: e.g., wavelength, pulse duration, energy, repetition rate, fiber core diameter. The surfaces of the cut tissue are comparable to cuts with conventional instruments. No carbonisation was observed. The temperature increase is below 40°C in the tissue surrounding the laser spot. The healing rate of an excimer laser cut is not slower than mechanical treatments; the quality is comparable.