Summary
The authors have been using CO2-laser radiation routinely for more than 2 years. After having recalled the basic thermal properties of this beam, they present their experience. The goal of this work is to point out the particular benefit of CO2-laser cautery to perform tumoral haemostasis. The technical data of this CO2-laser haemostasis are detailed for 3 main indications:
-
1.
In cases of a precise origin of the haemorrhage, the coagulation of small intratumoural vessel necessitates a low output power: 2–4 watts in continued emission; 10–15 watts in the pulsed mode. The beam must be defocussed so as to be as large as the aimed vessel. A micro-manipulatotor is necessary for deeply located tumours. Basal meningiomas, neurinomas, giant adenomas are the best indications.
-
2.
If a diffuse bleeding is encountered in the operative cavity the output must be a little higher: 3–8 watts in continuous mode or 15–30 watts in the pulsed mode; first the cavity is swept with a defocussed CO2-laser ray; then the few larger vessels which have not been cauterized are coagulated one by one either by laser or by bipolar coagulation.
-
3.
The insertion zone of a meningioma can be efficiently coagulated by CO2-laser: a 150–200 watts output in the pulsed mode is necessary if the attachment is dural, a 300–400 watts pulsed output in the case of bony infiltration.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Beck, O. J., The use of Nd-Yag and CO2-laser in neurosurgery. Neurosurg. Rev.2 (1980), 261–266.
Earle, K. M., Carpentier, S., Roessmann, U., Ross, M. A., Hayes, J. R., Zeitler, E., Central Nervous System effect of laser radiation. Federal Proceedings24 (1965), 129–142.
Fasano, V. A., The use of laser in neurosurgery. J. Neurosurg. Sci.26 (1982), 245–264.
Heppner, R., The laser scalpel on the nervous system. In: Laser Surgery II, Proceedings of 3rd Internat. Congress for Laser Surgery. Graz, 24–26 September 1979 (Kaplan, I., ed.). Jerusalem: Academic Press. 1978.
Jain, K. K., Handbook of Laser Surgery, 147 pp. Springfield, Ill.: Ch. C Thomas. 1983.
Lombard, G. E., Benech, F., Tealdi, S., Ponzio, R. M., Thermal effects on nervous human tissues under electro or laser surgery. J. Neurosurg. Sci.26 (1982), 265–271.
Roux, F. X., Chodkiewicz, J. P., Cioloca, C., Constans, J. P., Merienne, L., Justiniano, R., Intérêt et limites de l'utilisation du laser CO2 en neurochirurgie. Réflexions tirées d'une expérience française. Neurochirurgie5 (1984), 335–340.
Saunders, M. L., Young, H. F., Becker, D. P., Greenberg, R. P., Newlon, P. G., Corales, B. L., Ham, W. T., Poulishock, J. T., The use of the laser in neurological surgery. Surg. Neurol.14 (1980), 1–10.
Stellar, S., Experimental studies with carbondioxide laser as a Neurosurgical instrument. Med. Biol. Eng.8 (1974), 549–551.
Takisawa, T., Laser surgery of brain tumors. No. Shinkei Geta9 (1978), 743–746.
Wakaki, M., Yokota, H., Tanino, H., Nimsakul, N., Osada, M., Ishizuki, M., Izu, S., Thermal effect of the CO2-laser and our technic in dealing with it. In: Laser Surgery II, Proceedings of 3rd Internat. Congress for Laser Surgery (Kaplan, L, ed.), pp. 27–42. Graz, 24–26 September 1979.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Roux, F.X., Constans, J.P. & Chodkiewicz, J.P. Intracranial haemostasis with a neurosurgical CO2-laser unit. Acta neurochir 77, 37–40 (1985). https://doi.org/10.1007/BF01402303
Issue Date:
DOI: https://doi.org/10.1007/BF01402303