医用柔性CO_(2)激光传输介质研究进展与展望(特邀)

Research Progress and Perspective of Clinically Promising Flexible CO_(2) Laser Delivery Mediums(Invited)

中红外激光凭借其非接触、高效率和高精准度的显著优势,广泛应用于病变组织切除、组织整形和肿瘤间质光热疗法等临床外科手术中。在诸多中红外激光中,二氧化碳(CO_(2))激光具备极高消融效率和高精准度的特点,广泛应用于皮肤、耳鼻喉和腹腔等手术中。然而,由于缺乏稳定、高性能的小尺度柔性能量传输介质,CO_(2)激光无法像钬激光、钕激光等近红外激光一样,通过成熟的石英光纤,以微创或无创的方式进入体内,在人体内部自然腔道中进行微创介入操作。目前CO_(2)激光通常通过导光臂、空心波导管等传输介质进行手术,这极大地制约了其优势在微创手术中的充分体现。为使CO_(2)激光更好地服务于临床外科医疗领域,本文总结了现有的医用CO_(2)激光能量传输介质,重点讨论了热拉式多材料光纤技术在CO_(2)激光医疗领域的研究进展,并展望了未来多功能柔性CO_(2)激光消融机器人光纤的发展趋势及应用前景。

Mid-infrared (MIR) lasers offer substantial benefits,including non-contact operation,high efficiency,and precision,making them widely utilized in clinical surgical procedures such as lesion tissue removal,tissue plasticity,and tumor interstitial photothermal therapy.Notably,carbon dioxide (CO_2) lasers,among various MIR lasers,are extensively employed in skin,ear,nose,throat,and abdominal surgeries due to their exceptionally high ablation efficiency and precision.However,the lack of stable and high-performance small-scale,flexible laser energy-delivering mediums for CO_(2lasers) restricts their use in minimally invasive or noninvasive procedures,a capability present in mature silica fibers used in holmium,neodymium,and other near-infrared lasers for conducting minimally invasive interventional operations in natural cavities in vivo.Presently,CO_(2) laser procedures typically rely on energy-delivering mediums such as articulated arms and hollow waveguides but this considerably hampers the application of CO_(2) laser in minimally invasive surgeries.To enhance the role of CO_(2) lasers in clinical medicine,we review and summarize existing medical CO_(2) laser energy-delivering mediums,focusing on the advances in thermal-drawn multi-material fiber technology in CO_(2) laser surgery,and explore future development trends and applications of multifunctional flexible CO_(2) laser ablation robotic fibers.