This application addresses broad Challenge Area (06) Enabling Technologies and specific Challenge Topic, (06-DK-104) Enabling technology for the prevention and treatment of diseases. Urologic disease represents a debilitating medical problem that adversely affects the lives of people of all ages and backgrounds. Surgical lasers form the standard of care for many treatments and endoscopic procedures in the prostate, kidney, ureter, bladder, and urethra. Still, current state-of-the-art devices suffer from a number of limitations including limited adjustability of cutting and coagulating parameters and complex light delivery systems which are insufficiently flexible and yield a sub- optimal beam quality for fine work. These systems also tend to be large, inefficient, water-cooled, and expensive. Lockheed Martin Aculight has developed a proprietary flexible, low-cost architecture for a unique fiber laser design that represents a dramatic improvement over existing technologies in terms of performance, cost, size, and complexity. Based on the principles of infrared tissue ablation, the objective of the proposed work is to apply this technology in collaboration with Vanderbilt University and clinicians at the University of British Columbia to develop and test a highly efficient, compact ablative surgical tool. The device's output wavelength will be at 1.94?m which is proven to exhibit superior ablative and delivery qualities over currently available surgical laser systems. In this proposed work, Lockheed Martin Aculight will develop and test a thulium fiber laser that is capable of two distinct pulse modes, including a novel short pulse mode for fast cutting and a continuous wave mode. This unit will address the specific needs of several particular surgical applications from immediate vaporization with no effect outside of the irradiated zone, to precise ablation with minimal collateral thermal damage and lack of bleeding, to mass tissue removal with fine hemostatic control. The laser system will be further developed for commercialization to address a wide array of surgical applications following successful completion of these milestones. While most of the pulse features we propose here can be achieved today with existing laser sources, a separate source is required for short pulses and another for CW. The proposed device will readily generate each format and will cost less and be far more portable than currently available units, which have only a single mode of operation. The novelty of this device is in the improved technology that allows design of a single instrument that is high-performance, compact, low-cost, and scalable. Such a device can completely revolutionize the field as it provides a platform that can completely address the wide variety of surgical and outpatient needs in urology in both hospital and clinic settings. This basic laser architecture and microsurgical ablative capability will ultimately be applied to fields such as neurosurgery, orthopedics, surgical robotics, gastrological surgery, and otolaryngology to overcome existing limitations, pioneer new techniques, and ultimately improve patient care.
This project is intended to benefit those that require surgery for urology related treatment by developing a tool that can improve surgical outcome, increase the speed of a procedure, and reduce the associated cost to perform these procedures. This research will focus on overcoming the limitations prohibiting current surgical lasers from effectively treating a wide variety of urologic procedures, which will allow improved patient care.