Possibilities of lasers within NOTES

Abstract

Lasers possess unique properties that render them versatile light sources particularly for NOTES. Depending on the laser light sources used, diagnostic as well as therapeutic purposes can be achieved. The diagnostic potential offered by innovative concepts such as new types of ultra-thin endoscopes and optical probes supports the physician with optical information of ultra-high resolution, tissue discrimination and manifold types of fluorescence detection. In addition, the potential 3-D capability promises enhanced recognition of tissue type and pathological status. These diagnostic techniques might enable or at least contribute to accurate and safe procedures within the spatial restrictions inherent with NOTES. The therapeutic potential ranges from induction of phototoxic effects over tissue welding, coagulation and tissue cutting to stone fragmentation. As proven in many therapeutic laser endoscopic treatment concepts, laser surgery is potentially bloodless and transmits the energy without mechanical forces. Specialized NOTES endoscopes will likely incorporate suitable probes for improving diagnostic procedures, laser fibres with advantageous light delivery possibility or innovative laser beam manipulation systems. NOTES training centres may support the propagation of the complex handling and the safety aspects for clinical use to the benefit of the patient.

Key words::

• Laser
• diagnostic
• therapy
• optical coherence tomography
• photoacoustic
• confocal endoscopy
• coagulation
• vaporisation
• ablation
• laparoscopy
• NOTES

Declaration of interest: H. Stepp is member of the advisory board of Imalux company (OCT). The authors alone are responsible for the content and writing of the paper.