Comparison of laser-assisted damage in soft tissue using bi-directional and forward-firing optical fiber

Laser-assisted endoscopic surgery is made possible by employing optical devices such as fiber optics and hollow wave-guides. In some applications of laser-assisted endoscopic surgery, it is necessary to change the direction of the light emission. Our group reported a new fabrication method for bi-directional firing fibers. The conical surface of the fiber tip made the bi-directional emission of the laser light at the distal end of the fiber. In this study, we employed the bi-directional firing fiber for laser-assisted coagulation of soft tissue. The developed fiber and the normal forward-firing fiber are used for the endoscopic delivery system of a continuous IR laser into an in vitro porcine liver. The ablation and coagulation pattern were compared for two distinctive fiber systems. Regardless of the laser's parameters, the bi-directional firing fiber produced a cavity and coagulation zone with more or less a circular shape, while the forward fiber produced an elongated cavity and coagulation region. The bi-directional firing fiber produced wider and shorter coagulation and cavity zones compared to that of the forward-firing fiber. We expect the bi-directional firing fiber to be an excellent optical delivery system for endoscopic laser-hyperthermia when used against various tumors in the liver, breast and thyroid.