Summary
After summarising the main principles of the laser effect and the transmission of light by optical fibres the authors describe the main components of endoscopic photocoagulation equipment using a laser beam. Several teams have performed numerous photocoagulations on animals as well as weveral therapeutic trials on human subjects. The hæmostasis of hæmorrhagic lesions has been satisfactorily obtained both from the point of view of effectiveness and safety. However the best type of laser and optical fibre remain to be determined and more understanding is required of the mechanism of the action of laser rays on living tissue. Other methods of performing hæmostasis by endoscope using different techniques are also envisaged. Laser-photocoagulation seems to offer certain undeniable advantages over these techniques and promises to be the therapeutic method of the future. This is especially so since its field of application can be enlarged to other areas of operative endoscopy.
Résumé
Après avoir rappelé les grands principes de l'effet laser et de la transmission de la lumière par fibre optique, les auteurs décrivent les principaux constituants d'un matériel de photocoagulation endoscopique par rayon laser. Plusieurs équipes ont réalisé expérimentalement de nombreuses photocoagulations chez l'animal, ainsi que quelques essais thérapeutiques chez l'homme. L'hémostase des lésions hémorragiques est obtenu dans des conditions satisfaisantes tant sur le plan de l'efficacité que de la sécurité. Toutefois, il reste encore à définir le type de laser et de fibre optique les mieux adaptés, et à progresser dans la connaissance du mécanisme d'action du rayon laser sur les tissues vivants. D'autres méthodes destinées à assurer l'hémostase per endoscopique des lésions hémorragiques mais faisant appel à des techniques différentes sont également envisagées. La photocoagulation laser semble posséder d'indéniables avantages sur ces divers procédés, et apparaît être une thérapeutique d'avenir, d'autant plus qu'il est possible que son champ d'application soit élargi à d'autres domaines de l'endoscopie opératoire.
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Brunetaud, J.M., Maffioli, C. & Miro, L. The laser in digestive endoscopy. Acta Endosc 7, 69–88 (1977). https://doi.org/10.1007/BF02973610
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DOI: https://doi.org/10.1007/BF02973610