| Theme |
Laser Endoscopy in Theory and Practice --Perspective of GI Endoscopy in the 21st Century |
| Title |
High-power Diode Laser Treatment for Early Gastric Cancer Enhanced by Submucosal Injection of ICG Solution |
| Author |
Takuya Hayashi |
Department of Medical Engineering, National Defense Medical Collage |
| [ Summary ] |
High-power diode laser irradiation with indocyanine green (ICG) solution injection into the submucosal layer was evaluated for treatment of early cancer of the alimentary tract. The injected ICG solution was used to absorption of diode laser light into the submucosal tissue. The ICG dyed layer also prevents direct laser penetration into musclaris propriae and protects it from damage. We proved that a 1mg/ml solution was suitable for this therapy. Furthermore merit was seen in the fact that we could easily judge the ablated depth of invasion by observing the surface color. We presented three cases of early gastric cancer, which were successfully treated through this method. We also developed a new mucosal cutting method, using diode laser ablation, with submucosal injection of ICG solution to perform endoscopic mucosal resection of large lesions. The sharp incision produced a slight coagulative layer. Esophageal varices are also target for the ICG enhanced diode ablation. Complete fibrosis of the submucosa was realized through this method without bleeding or perforation. The combination of ICG and diode laser is considered useful in the treatment of alimentary diseases. |