Experimental modeling of laser thermoplasty of costal cartilage
- 1 к.м.н., руководитель учебно-клинического отдела, Государственное бюджетное учреждение здравоохранения г. Москвы «НИИ неотложной детской хирургии и травматологии» Департамента здравоохранения г. Москвы
- 2 врач-хирург отделения хирургии, Муниципальное бюджетное учреждение здравоохранения «Домодедовская центральная городская больница»
- 3,4,6 науч. сотрудник, Федеральное государственное бюджетное учреждение науки Институт проблем лазерных и информационных технологий РАН
- 5 к.ф.-м.н., вед. науч. сотрудник, Федеральное государственное бюджетное учреждение науки Институт проблем лазерных и информационных технологий РАН
- 7 д.х.н., доцент, химический факультет, Московский государственный университет им. М.В. Ломоносова
- 8 к.т.н., ст. науч. сотрудник, Научно-техническое объединение «ИРЭ-Полюс» (Моск. обл., г. Фрязино)
- 9 д.м.н., профессор, зам. директора по науке, Государственное бюджетное учреждение здравоохранения г. Москвы «НИИ неотложной детской хирургии и травматологии» Департамента здравоохранения г. Москвы
- 10 д.ф.-м.н., профессор, зав. отделом, Федеральное государственное бюджетное учреждение науки Институт проблем лазерных и информационных технологий РАН
Abstract
Shaping of whole costal cartilage of human using laser radiation is modeled. Such problem arises at medical cure of chest wall deformities of kids or when one fabricated some kind of cartilage implants. By now in the medical practice doctors performed successfully the laser thermoplasty of nasal septum and auricular, the technology of trachea implants is developed using costal cartilage plates of appropriate thickness. The distinctive feature of assigned task is that the thickness of costal cartilage attained 5-10 mm. For reshaping it is necessary to provide the heating of considerable volume of the tissue up to 70-80 С. Moreover, the temperature rise of cartilage areas which adjoined to chest pleura should be not exceeds 10-15 С. The required conditions were succeeded to realize with Raman fiber laser emitted at wavelength 1.68 m. This laser was recently developed in «IRE Polus» (Fryazino, Russia) and is very perspective for solving a number of specific medical problems. For cartilage thermoplasty it used for a first time. The dynamic of temperature fields induced in the pig costal cartilage under the laser irradiation was studied ex vivo using thermograph. Analysis of the thermometry data allowed us to determine optimal regimes of laser treatment satisfying the requirements to temperature field. The dynamic of supporting force of cartilage during reshaping procedure was studied using tensometric device.
Conditions of stable relaxation of internal mechanical stresses when cartilage attained a new shape were determined. After the procedure of laser treatment the bent cartilage partially recover its initial shape. It is shown that the main return of deformed cartilage to its initial shape occur during first hours after laser procedure. The stable bend measured as the ratio of arc high and base appeared to about 60% of its initial value.
Thus, the ability of stable laser thermoplasty of whole costal cartilage was demonstrated in this work and parameters of laser irradiation and regimes of laser treatment were determined. It opened good perspectives for development of new approaches of curing wall chest deformities, based on the laser engineering of cartilage.
How to cite
Плякин В.А., Кулик И.О., Захаркина О.Л., Воробьёва Н.Н., Свиридов А.П., Баграташвили Н.В., Игнатьева Н.Ю., Минаев В.П., Саруханян О.О., Баграташвили В.Н. Экспериментальное моделирование лазерной термопластики реберных хрящей // Биомедицинская радиоэлектроника. 2014. № 1. С. 43–48.
References
- Bagratashvili V.N., Sobol' E'.N., Shexter A. Lazernaya inzheneriya xryashhej. M.: Fizmatlit. 2006. 488 s.
- Molik K.A., Engum S.A., Rescorla F.J. et al. Pectus excavatum repair: Experience with standard and minimal invasive techniques // J. Pediatr. Surg. 2001. V. 36(2). P. 324-328.
- Shamberger R.C. Congenital chest wall deformities. In: O'Neill Jr. J.A., Rowe M.I., Grosfeld J.L., et al. (Eds). Pediatric Surgery. 5th ed. St. Louis. Mosby. 1998. P. 894-921.
- Frantz F.W. Indications and guidelines for pectus exca-vatum repair Current Opinion in Pediatrics. 2011. V. 23(4). P. 486-491.
- Williams A.M., Crabbe D.C. Pectus deformities of the anterior chest wall. Paediatr. Respir. Rev. 2003. V. 4. P. 237-242.
- Dato G., Sansone F., Flocco R., Zingarelli E. Nuss procedure for all? But all are not equal! // European Journal of Cardio-Thoracic Surgery. 2012. V. 41. P. 724.
- Nasr A., Fecteau A., Wales P.W. Comparison of the Nuss and the Ravitch procedure for pectus excavatum repair: a meta-analysis // J. Pediatr. Surg. 2010. V. 45(5). P. 880-886.
