Development and Characterization of Novel Optical Delivery Device for Endoscopic Laser Treatment of Gastrointestinal Diseases
- Alternative Title
- 위장 질환의 내시경 레이저 치료를 위한 새로운 광학 전달 장치의 개발 및 특성화
- Abstract
- Gastrointestinal (GI) diseases are the most common problems in the digestive system, with an incidence that has increased gradually over recent decades. The global GI therapeutics market size was valued at about 36 billion dollars in 2020, and revenue force cast will reach more than 65 billion dollars in 2025. Although many techniques have been provided to enhance treatment efficacy as well as to decrease hospitalizations cost, pancreatic cancer (PC), common bile duct (CBD) stenosis, and GI bleeding are still challenging in GI diseases.
The goal of this dissertation is to develop and characterize novel optical delivery devices for endoscopic laser treatment of gastrointestinal diseases, including PC, CBD stenosis, and GI bleeding with enhanced safety. Depending on diseases type, specific optical delivery devices with optimal treatment conditions are developed to improve ablation performance to obtain minimal undesirable tissue damage.
Firstly, we demonstrated that the degree of conical angle tips was a deterministic factor to achieve cylindrical interstitial laser ablation (CILA) from diffusing applicators. We then proved the feasibility of CILA in porcine pancreatic tissue to develop an Endoscopic Ultrasound (EUS)-guided pancreatic cancer ablation method with enhanced safety. The therapeutic capacity of multiple diffusing ablations of the porcine pancreas was also evaluated with the Nd:YAG laser in ex vivo and in vivo mini-pig models. Mini-pig tests with EUS confirmed high durability and smooth insertion of the diffusing fiber. Secondly, we developed a novel balloon catheter-integrated diffusing applicator (BCDA) in common bile duct (CBD) tissue to develop an ECRP-guided CBD stenosis ablation technique with enhanced safety. We demonstrated that air removal from a balloon via deflations was critical for achieving symmetric light distribution and uniform coagulation necrosis in tubular tissue. Besides, in vivo mini-pig tests with endoscopic retrograde cholangiopancreatography (ECRP) confirmed no difficulty and high durability of the BCDA device. Finally, we reported the potency of a new optical treatment using dual-wavelengths (532 nm and 980 nm) for achieving noncontact thermal hemostasis on venous and arterial bleeders in in vivo rabbit ear models to develop an endoscopic hemostasis technique. The collective thermal effect from the combined wavelengths significantly reduces operating time and a high success rate of complete hemostasis on rabbit models. Further in vivo mini-pig studies will investigate the novel therapeutic optical devices on disease-developed animal models to evaluate the chronic responses of tissue for GI diseases as well as to prepare clinical trials.
- Issued Date
- 2022
- Awarded Date
- 2022. 2
- Type
- Dissertation
- Publisher
- 부경대학교
- Affiliation
- Pukyong National University, Graduate school
- Department
- 대학원 4차산업융합바이오닉스공학과
- Advisor
- Hyun Wook Kang
- Table Of Contents
- Chapter 1 : Introduction 1
1.1. Motivation 1
1.2. The goal of research and objective statement 3
1.3. Organization of Thesis 3
1.4. References 7
Chapter 2 : Laser Ablation 9
2.1. Mechanism of laser tissue interaction 9
2.2. Treatment factors for laser ablation (LA) 10
2.2.1. Laser Wavelength 11
2.2.2. Laser settings 13
2.2.3. The design of optical delivery device 13
2.3. References 14
Chapter 3 : Spatial effect of conical angle on optical-thermal distribution for circumferential photocoagulation 15
3.1. Abstract 15
3.2. Introduction 15
3.3. Materials and Methods 18
3.3.1. Design of diffusing elements 18
3.3.2. Ex vivo experiment 21
3.4. Results 24
3.5. Discussion 34
3.6. Conclusion 38
3.7. References 38
Chapter 4 : Endoscopic Ultrasound (EUS)-guided cylindrical interstitial laser ablation (CILA) on in vivo porcine pancreas 42
4.1. Abstract 42
4.2. Introduction 42
4.3. Materials and Methods 47
4.3.1 Fiber preparation 47
4.3.2 Numerical simulations 49
4.3.3 Ex vivo CILA tests 52
4.3.4 In vivo CILA tests 54
4.3.5 Quantification 55
4.3.6 Statistical Analysis 56
4.4. Results 57
4.5. Discussion 65
4.6. Conclusion 70
4.7. References 71
Chapter 5 : Multiple cylindrical laser ablation of porcine pancreas: ex and in vivo validations 75
5.1. Abstract 75
5.2. Introduction 76
5.3. Materials and Methods 80
5.3.1 Numerical simulation 80
5.3.2 Ex vivo multiple ablation tests 81
5.2.3 In vivo multiple CILAs tests 84
5.2.4 Quantification 85
5.2.5 Statistical analysis 86
5.4. Results 86
5.5. Discussion 93
5.6. Conclusion 97
5.7. Supplementary Documents 98
5.7.1 Supplementary Materials and Methods 98
5.7.2 Supplementary Figures: 105
5.8. References 107
Chapter 6 : Optical-thermal effects of residual air trap in balloon on laser treatment of tubular tissue 110
6.1. Abstract 110
6.2. Introduction 112
6.3. Materials and Methods 114
6.3.1 Device preparation 114
6.3.2 Air trap evaluations 115
6.3.3 Optical simulation 117
6.3.4 Thermal simulation 118
6.3.5 Ex vivo experiment 124
6.3.6 Quantitative evaluations 124
6.3.7 Statistical analysis 125
6.4. Results 126
6.5. Discussion 136
6.6. Conclusion 140
6.7. References 141
Chapter 7 : Novel endoscopic laser treatment of common bile duct stenosis using balloon catheter-integrated diffusing applicator (BCDA) 145
7.1. Abstract 145
7.2. Introduction 146
7.3. Materials and Methods 147
7.3.1 The integrated device preparation 147
7.3.2. Ex vivo and in vivo leporine ear model validations 149
7.3.3 In vivo mini-pig test 150
7.4. Results and Discussion 150
7.5. Conclusion 154
7.6. References 155
Chapter 8 : Noncontact rapid photothermal hemostasis using dual-wavelengths on venous and arterial bleeding in in vivo leporine models 156
8.1. Abstract 156
8.2. Introduction 157
8.3. Materials and Methods 159
8.3.1 Bleeder Models 159
8.3.2 Light Source 160
8.3.3 Hemostatic Experiments 161
8.3.4 Numerical Simulation 162
8.3.5 Histological Evaluation 164
8.4. Results 165
8.5. Discussion 176
8.6. Conclusion 180
8.7. References 180
Chapter 9 : Effect of spatial light distribution on thermal response of vascular tissue 183
9.1. Abstract 183
9.2. Introduction 183
9.3. Materials and Methods 185
9.3.1 Fiber preparation 185
9.3.2 Ex vivo experiment 187
9.4 Statistical analysis 191
9.5. Results 192
9.5.1 Light distribution comparison 192
9.5.2 Leporine vein model 193
9.5.3 Bovine vein model 200
9.6. Discussion 202
9.7. Conclusion 207
9.8. References 208
Chapter 10 : Conclusions and Future studies 212
10.1. Finding 212
10.2. Future directions 214
CURRICULUM VITAE 217
- Degree
- Doctor
- Appears in Collections:
- 대학원 > 4차산업융합바이오닉스공학과
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