Nd:YAG激光刀兔肝叶切除实验及电子显微镜的观察

为改进肝脏外科手术,除试制肝脏切除的特殊器械外,我们针对存在的一些问题,如时间长、出血多、并发症多、死亡率高等,应用掺钕 YAG 连续激光作为“激

An experimental study and observation by electron microscope on rabbits’liver resection by CW Nd:YAG laser as light scalpel

Pantial liver lobe resection with a CW Nd-YAG laser as light scalpel were carried out in ten adult rabbits,which showed the usefulness of the focused Nd-YAG laser beam in liver surgery. The output power of the laser was 15～20 watts.Measurement of SGPT and blood routine were made preoperatively and postoperatively.The cut edge was bloodless with a 1～3 mm layer of carbonization and coagulation at the surrouding tissure.24 hrs after operation,SGPT increased to more than 130 units,and blood hemoglobin decreased seriously.Both SGPT and blood hemoglobin returned to normal level 7 days after operation.Under microscope,agglutinations of erythrocyte in venules was observed within the necrotic zone 2 mm from the cut edge.The submicroscopic structure of the hepatic cells observed by electron microscope showed different degree of thenmal damage according to their distance from the cut edge.Within distance of 3 mm from the cut edge,the submicroscopic structure was not complete,however,those situated 4～5 mm from the cut edge showed complete submicroscopic structure.Autopsy perfomed 1 to 3 months postoperatively revealed satisfactory healing and liver regeneration without infection.