This video "Ex vivo" shows a dissection of muscle tissue with 3 channels of laser MUL at max power. The scale of the shooting is a different, because 3 channels were shot separately. Visible diameter of light guide is less 1 mm. This allows us to determine the size zone of the primary of coagulation by whitening on tissues. We can see, that:
1.The whitening area near the dissection is the zone of primary coagulation. This zone determines the zone of hemostasis immediately during the dissection of tissues. This is important for the surgeon to perform the operation. This zone determines the diameter of the blood vessels, which will be hemostasis immediately upon dissection. It is believed that hemostasis of the vessels will be approximately 2 times less than the size of the zone of primary coagulation.
2.* In fact, there are many factors that influences the size of the vessels, which will be coagulated immediately after dissection: the degree of vascularization of the tissue, intensity of blood flow, venous or arterial blood, the degree of viscosity of the blood, degree of saturation with oxygen (content of oxyhemoglobin), medicines taken by the patient, etc. ** The same factors influences the depth of penetration of the laser beam. *** This also depends on the laser power and the speed of the tip of the light guide. The faster the movement, the shorter the impact and the less depth. The more power, the stronger the impact and the more depth. Therefore, two methods can be highlight:
A - low power and low speed of the light guide - this gives an accurate slow dissection.
B - high power and high speed of the light guide - this gives an accurate rapid dissection.
3. Within about 1 day the zone of necrosis will increase, since there is a zone of tissues that are not coagulated immediately, but have received thermal damage that will lead to functional death of tissue cells. Therefore, the zone of secondary coagulation is ALWAYS greater.
4. The 1,064 μm channel penetrates deeply and deeply into the tissue **. In pure water, it penetrates more than 100 mm. In tissues, penetration is significantly less due to the turbidity of the tissues and the blood content *. Therefore, its primary coagulation zone is very large ( 5-10 mm ). The zone of secondary coagulation is still much larger. This can be seen in the video.
5. The 1.32 μm channel penetrates into the tissue with medium degree. In pure water, it penetrates about 1 mm. In the tissues a little more because of the spread of heat through the tissues and the thermal conductivity of the tissues. Therefore, its primary coagulation zone is small ( 2-5 mm ). The zone of secondary coagulation is something larger. This can be seen in the video.
6. The 1.44 μm channel penetrates very little into the tissue **. In pure water, it penetrates about 0.3 mm. In tissues, the penetration is slightly greater because of the heat spreading through the tissues and the thermal conductivity of the tissues. Therefore, its primary coagulation zone is minimal ( 1-2 mm ). The zone of secondary coagulation is insignificantly larger. This can be seen in the video.
7. THAN MORE PENETRATION OF THE BEAM, THE MORE SECONDARY COAGULATION ZONE! This is very important for the surgeon! He should forecast - what zone of tissues will be damaged THEN - after the operation ... In the zone of secondary coagulation, there should be no important tissues and organs: skin, vessels, nerves, duct wall, stomach wall, kidney, eye, etc. Therefore, a doctor using a three wave surgical apparatus has a unique opportunity to choose what is EFFECTIVE and SAFE!