TREATMENT GUIDELINES FOR ENDOSCOPIC HIGH REACTIVE LEVEL LASER TREATMENT ( HLLT ) OF THE GASTRO-INTESTINAL TRACT

Abstract

The treatment principle of endoscopic high reactive level laser treatment (HLLT) of the gastrointestinal tract is the vaporization and coagulation of the diseased lesion. Histological changes are caused by the photothermal reaction which is directly related to the increase of temperature of the laser-irradiated field. High outputs of 60 to 100 W can cause tissue to vaporize while outputs of 20 to 50 W can cause protein denaturation and coagulation. The amount and degree of tissue damage is dictated by the energy density (output x irradiation time/cm²) of the incident laser. At lower outputs of 2 to 3 W, laserthermia is anticipated, however using a high output hardware to achieve this is unadvisable and a specific hardware intended for this purpose should be used. When output of a laser mistaken, dangers of perforation and burning of the scope arise. The purpose of these Safety Guidelines is to provide information for the proper use of lasers in order to secure the safety of both the patient and the physician during the use of lasers in endoscopic procedures of the digestive tract.