Search results for: wet chemical ablation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4468

Search results for: wet chemical ablation

4468 Modified Model for UV-Laser Corneal Ablation

Authors: Salah Hassab Elnaby, Omnia Hamdy, Aziza Ahmed Hassan, Salwa Abdelkawi, Ibrahim Abdelhalim

Abstract:

Laser corneal reshaping has been proposed as a successful treatment of many refraction disorders. However, some physical and chemical demonstrations of the laser effect upon interaction with the corneal tissue are still not fully explained. Therefore, different computational and mathematical models have been implemented to predict the depth of the ablated channel and calculate the ablation threshold and the local temperature rise. In the current paper, we present a modified model that aims to answer some of the open questions about the ablation threshold, the ablation rate, and the physical and chemical mechanisms of that action. The proposed model consists of three parts. The first part deals with possible photochemical reactions between the incident photons and various components of the cornea (collagen, water, etc.). Such photochemical reactions may end by photo-ablation or just the electronic excitation of molecules. Then a chemical reaction is responsible for the ablation threshold. Finally, another chemical reaction produces fragments that can be cleared out. The model takes into account all processes at the same time with different probabilities. Moreover, the effect of applying different laser wavelengths that have been studied before, namely the common excimer laser (193-nm) and the solid state lasers (213-nm & 266-nm), has been investigated. Despite the success and ubiquity of the ArF laser, the presented results reveal that a carefully designed 213-nm laser gives the same results with lower operational drawbacks. Moreover, the use of mode locked laser could also decrease the risk of heat generation and diffusion.

Keywords: UV lasers, mathematical model, corneal ablation, photochemical ablation

Procedia PDF Downloads 49
4467 Applications of Nanoparticles via Laser Ablation in Liquids: A Review

Authors: Fawaz M. Abdullah, Abdulrahman M. Al-Ahmari, Madiha Rafaqat

Abstract:

Laser ablation of any solid target in the liquid leads to fabricate nanoparticles (NPs) with metal or different compositions of materials such as metals, alloys, oxides, carbides, hydroxides. The fabrication of NPs in liquids based on laser ablation has grown up rapidly in the last decades compared to other techniques. Nowadays, laser ablation has been improved to prepare different types of NPs with special morphologies, microstructures, phases, and sizes, which can be applied in various fields. The paper reviews and highlights the different sizes, shapes and application field of nanoparticles that are produced by laser ablation under different liquids and materials. Also, the paper provides a case study for producing a titanium NPs produced by laser ablation submerged in distilled water. The size of NPs is an important parameter, especially for their usage and applications. The size and shape have been analyzed by SEM, (EDAX) was applied to evaluate the oxidation and elements of titanium NPs and the XRD was used to evaluate the phase composition and the peaks of both titanium and some element. SEM technique showed that the synthesized NPs size ranges were between 15-35 nm which can be applied in various field such as annihilator for cancerous cell etc.

Keywords: nanoparticles, laser ablation, titanium NPs, applications

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4466 Spectroscopic Characterization Approach to Study Ablation Time on Zinc Oxide Nanoparticles Synthesis by Laser Ablation Technique

Authors: Suha I. Al-Nassar, K. M. Adel, F. Zainab

Abstract:

This work was devoted for producing ZnO nanoparticles by pulsed laser ablation (PLA) of Zn metal plate in the aqueous environment of cetyl trimethyl ammonium bromide (CTAB) using Q-Switched Nd:YAG pulsed laser with wavelength= 1064 nm, Rep. rate= 10 Hz, Pulse duration= 6 ns and laser energy 50 mJ. Solution of nanoparticles is found stable in the colloidal form for a long time. The effect of ablation time on the optical and structure of ZnO was studied is characterized by UV-visible absorption. UV-visible absorption spectrum has four peaks at 256, 259, 265, 322 nm for ablation time (5, 10, 15, and 20 sec) respectively, our results show that UV–vis spectra show a blue shift in the presence of CTAB with decrease the ablation time and blue shift indicated to get smaller size of nanoparticles. The blue shift in the absorption edge indicates the quantum confinement property of nanoparticles. Also, FTIR transmittance spectra of ZnO2 nanoparticles prepared in these states show a characteristic ZnO absorption at 435–445cm^−1.

Keywords: zinc oxide nanoparticles, CTAB solution, pulsed laser ablation technique, spectroscopic characterization

Procedia PDF Downloads 349
4465 Coaxial Helix Antenna for Microwave Coagulation Therapy in Liver Tissue Simulations

Authors: M. Chaichanyut, S. Tungjitkusolmun

Abstract:

This paper is concerned with microwave (MW) ablation for a liver cancer tissue by using helix antenna. The antenna structure supports the propagation of microwave energy at 2.45 GHz. A 1½ turn spiral catheter-based microwave antenna applicator has been developed. We utilize the three-dimensional finite element method (3D FEM) simulation to analyze where the tissue heat flux, lesion pattern and volume destruction during MW ablation. The configurations of helix antenna where Helix air-core antenna and Helix Dielectric-core antenna. The 3D FEMs solutions were based on Maxwell and bio-heat equations. The simulation protocol was power control (10 W, 300s). Our simulation result, both helix antennas have heat flux occurred around the helix antenna and that can be induced the temperature distribution similar (teardrop). The region where the temperature exceeds 50°C the microwave ablation was successful (i.e. complete destruction). The Helix air-core antenna and Helix Dielectric-core antenna, ablation zone or axial ratios (Widest/length) were respectively 0.82 and 0.85; the complete destructions were respectively 4.18 cm³ and 5.64 cm³.

Keywords: liver cancer, Helix antenna, finite element, microwave ablation

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4464 Numerical Simulation of Heating Characteristics in a Microwave T-Prong Antenna for Cancer Therapy

Authors: M. Chaichanyut, S. Tungjitkusolmun

Abstract:

This research is presented with microwave (MW) ablation by using the T-Prong monopole antennas. In the study, three-dimensional (3D) finite-element methods (FEM) were utilized to analyse: the tissue heat flux, temperature distributions (heating pattern) and volume destruction during MW ablation in liver cancer tissue. The configurations of T-Prong monopole antennas were considered: Three T-prong antenna, Expand T-Prong antenna and Arrow T-Prong antenna. The 3D FEMs solutions were based on Maxwell and bio-heat equations. The microwave power deliveries were 10 W; the duration of ablation in all cases was 300s. Our numerical result, heat flux and the hotspot occurred at the tip of the T-prong antenna for all cases. The temperature distribution pattern of all antennas was teardrop. The Arrow T-Prong antenna can induce the highest temperature within cancer tissue. The microwave ablation was successful when the region where the temperatures exceed 50°C (i.e. complete destruction). The Expand T-Prong antenna could complete destruction the liver cancer tissue was maximized (6.05 cm³). The ablation pattern or axial ratio (Widest/length) of Expand T-Prong antenna and Arrow T-Prong antenna was 1, but the axial ratio of Three T-prong antenna of about 1.15.

Keywords: liver cancer, T-Prong antenna, finite element, microwave ablation

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4463 Production, Quality Control and Biodistribution Assessment of 166 Ho-BPAMD as a New Bone Seeking Agent

Authors: H. Yousefnia, N. Amraee, M. Hosntalab, S. Zolghadri, A. Bahrami-Samani

Abstract:

The aim of this study was the preparation of a new agent for bone marrow ablation in patients with multiple myeloma. 166Ho was produced at Tehran research reactor via 165Ho(n,γ)166Ho reaction. Complexion of Ho‐166 with BPAMD was carried out by the addition of about 200µg of BPAMD in absolute water to 1 mci of 166HoCl3 and warming up the mixture 90 0C for 1 h. 166Ho-BPAMD was prepared successfully with radio chemical purity of 95% which was measured by ITLC method. The final solution was injected to wild-type mice and bio distribution was determined up to 48 h. SPECT images were acquired after 2 and 48 h post injection. Both the bio distribution studies and SPECT imaging indicated high bone uptake, while accumulation in other organs was approximately negligible. The results show that 166Ho-BPAMD has suitable characteristics and can be used as a new bone marrow ablative agent.

Keywords: bone marrow ablation, BPAMD, 166Ho, SPECT

Procedia PDF Downloads 476
4462 3D-printing for Ablation Planning in Patients Undergoing Atrial Fibrillation Ablation: 3D-GALA Trial

Authors: Terentes Printzios Dimitrios, Loanna Gourgouli, Vlachopoulos Charalambos

Abstract:

Aims: Atrial fibrillation (AF) remains one of the major causes of stroke, heart failure, sudden death and cardiovascular morbidity. Ablation techniques are becoming more appealing after the latest results of randomized trials showing the overall clinical benefit. On the other hand, imaging techniques and the frontier application of 3D printing are emerging as a valuable ally for cardiac procedures. However, no randomized trial has directly assessed the impact of preprocedural imaging and especially 3D printing guidance for AF ablation. The present study is designed to investigate for the first time the effect of 3D printing of the heart on the safety and effectiveness of the ablation procedure. Methods and design: The 3D-GALA trial is a randomized, open-label, controlled, multicentre clinical trial of 2 parallel groups designed to enroll a total of 100 patients undergoing ablation using cryo-balloon for paroxysmal and persistent AF. Patients will be randomized with a patient allocation ratio of 1: 1 to preprocedural MRI scan of the heart and 3D printing of left atrium and pulmonary veins and cryoablation versus standard cryoablation without imaging. Patients will be followed up to 6 months after the index procedure. The primary outcome measure is the reduction of radiation dose and contrast amount during pulmonary veins isolation. Secondary endpoints will include the percentage of atrial fibrillation relapse at 24h-Holter electrocardiogram monitoring at 6 months after initial treatment. Discussion: To our knowledge, the 3D-GALA trial will be the first study to provide evidence about the clinical impact of preprocedural imaging and 3D printing before cryoablation.

Keywords: atrial fibrillation, cardiac MRI, cryoablation, 3-d printing

Procedia PDF Downloads 146
4461 Nanotechnology-Based Treatment of Klebsiella pneumoniae Infections

Authors: Lucian Mocan, Teodora Mocan, Matea Cristian, Cornel Iancu

Abstract:

We present method of nanoparticle enhanced laser thermal ablation of Klebsiella pneumoniae infections, using gold nanoparticles combined with a specific growth factor and demonstrate its selective therapeutic efficacy. Ab (antibody solution) bound to GNPs (gold nanoparticles) was administered in vitro and determined the specific delivery of the nano-bioconjugate into the microorganism. The extent of necrosis was considerable following laser therapy, and at the same time, normal cells were not seriously affected. The selective photothermal ablation of the infected tissue was obtained after the selective accumulation of Ab bound to GNPs into bacteria following perfusion. These results may represent a major step in antibiotherapy treatment using nanolocalized thermal ablation by laser heating.

Keywords: gold nanoparticles, Klebsiella pneumoniae, nanoparticle functionalization, laser irradiation, antibody

Procedia PDF Downloads 393
4460 Study on Fabrication of Surface Functional Micro and Nanostructures by Femtosecond Laser

Authors: Shengzhu Cao, Hui Zhou, Gan Wu, Lanxi Wanhg, Kaifeng Zhang, Rui Wang, Hu Wang

Abstract:

The functional micro and nanostructures, which can endow material surface with unique properties such as super-absorptance, hydrophobic and drag reduction. Recently, femtosecond laser ablation has been demonstrated to be a promising technology for surface functional micro and nanostructures fabrication. In this paper, using femtosecond laser ablation processing technique, we fabricated functional micro and nanostructures on Ti and Al alloy surfaces, test results showed that processed surfaces have 82%~96% absorptance over a broad wavelength range from ultraviolet to infrared. The surface function properties, which determined by micro and nanostructures, could be modulated by variation laser parameters. These functional surfaces may find applications in such areas as photonics, plasmonics, spaceborne devices, thermal radiation sources, solar energy absorbers and biomedicine.

Keywords: surface functional, micro and nanostructures, femtosecond laser, ablation

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4459 The Effect of Choke on the Efficiency of Coaxial Antenna for Percutaneous Microwave Coagulation Therapy for Hepatic Tumor

Authors: Surita Maini

Abstract:

There are many perceived advantages of microwave ablation have driven researchers to develop innovative antennas to effectively treat deep-seated, non-resectable hepatic tumors. In this paper a coaxial antenna with a miniaturized sleeve choke has been discussed for microwave interstitial ablation therapy, in order to reduce backward heating effects irrespective of the insertion depth into the tissue. Two dimensional Finite Element Method (FEM) is used to simulate and measure the results of miniaturized sleeve choke antenna. This paper emphasizes the importance of factors that can affect simulation accuracy, which include mesh resolution, surface heating and reflection coefficient. Quarter wavelength choke effectiveness has been discussed by comparing it with the unchoked antenna with same dimensions.

Keywords: microwave ablation, tumor, finite element method, coaxial slot antenna, coaxial dipole antenna

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4458 Labyrinthine Venous Vasculature Ablation for the Treatment of Sudden Sensorineural Hearing Loss: Two Case Reports

Authors: Kritin K. Verma, Bailey Duhon, Patrick W. Slater

Abstract:

Objective: To introduce the possible etiological role that the Labyrinthine Venous Vasculature (LVV) has in venous congestion of the cochlear system in Sudden Sensorineural Hearing Loss (SSNHL) patients. Patients: Two patients (62-year-old female, 50-year-old male) presented within twenty-four hours of onset of SSNHL. Intervention: Following failed conservative and salvage techniques, the patients underwent ablation of the labyrinthine venous vasculature ipsilateral to the side of the loss. Main Outcome Measures: Improvement of sudden SSNHL based on an improvement of pure-tone audiometric (PTA) low-tone scoring averages at 250, 500, and 1000 Hz. Word recognition scoring using the NU-6 word list was used to assess quality of life. Results: Case 1 experienced a 51.7 dB increase in low-tone PTA and an increased word recognition scoring of 90%. Case 2 experienced a 33.4 dB increase in low-tone PTA and 60% increase in word recognition score. No major complications noted. Conclusion: Two patients experienced significant improvement in their low-tone PTA and word recognition scoring following the labyrinthine venous vasculature ablation.

Keywords: case report, sudden sensorineural hearing loss, venous congestion, vascular ablation

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4457 Infra Red Laser Induced Ablation of Graphene Based Polymer Nanocomposites

Authors: Jadranka Blazhevska Gilev

Abstract:

IR laser-induced ablation of poly(butylacrylate-methylmethacrylate/hydroxyl ethyl methacrylate)/reduced graphene oxide (p(BA/MMA/HEMA)/rGO) was examined with 0.5, 0.75 and 1 wt% reduced graphene oxide content in relation to polymer. The irradiation was performed with TEA (transversely excited atmosphere) CO₂ laser using incident fluence of 15-20 J/cm², repetition frequency of 1 Hz, in an evacuated (10-3 Pa) Pyrex spherical vessel. Thin deposited nanocomposites films with large specific area were obtained using different substrates. The properties of the films deposited on these substrates were evaluated by TGA, FTIR, (Thermogravimetric analysis, Fourier Transformation Infrared) Raman spectroscopy and SEM microscopy. Homogeneous distribution of graphene sheets was observed from the SEM images, making polymer/rGO deposit an ideal candidate for SERS application. SERS measurements were performed using Rhodamine 6G as probe molecule on the substrate Ag/p(BA/MMA/HEMA)/rGO.

Keywords: laser ablation, reduced graphene oxide, polymer/rGO nanocomposites, thin deposited film

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4456 Creation of GaxCo1-xZnSe0.4 (x = 0.1, 0.3, 0.5) Nanoparticles Using Pulse Laser Ablation Method

Authors: Yong Pan, Li Wang, Xue Qiong Su, Dong Wen Gao

Abstract:

To date, nanomaterials have received extensive attention over the years because of their wide application. Various nanomaterials such as nanoparticles, nanowire, nanoring, nanostars and other nanostructures have begun to be systematically studied. The preparation of these materials by chemical methods is not only costly, but also has a long cycle and high toxicity. At the same time, preparation of nanoparticles of multi-doped composites has been limited due to the special structure of the materials. In order to prepare multi-doped composites with the same structure as macro-materials and simplify the preparation method, the GaxCo1-xZnSe0.4 (x = 0.1, 0.3, 0.5) nanoparticles are prepared by Pulse Laser Ablation (PLA) method. The particle component and structure are systematically investigated by X-ray diffraction (XRD) and Raman spectra, which show that the success of our preparation and the same concentration between nanoparticles (NPs) and target. Morphology of the NPs characterized by Transmission Electron Microscopy (TEM) indicates the circular-shaped particles in preparation. Fluorescence properties are reflected by PL spectra, which demonstrate the best performance in concentration of Ga0.3Co0.3ZnSe0.4. Therefore, all the results suggest that PLA is promising to prepare the multi-NPs since it can modulate performance of NPs.

Keywords: PLA, physics, nanoparticles, multi-doped

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4455 Nanotechnology-Based Treatment of Liver Cancer

Authors: Lucian Mocan

Abstract:

We present method of Nanoparticle enhanced laser thermal ablation of HepG2 cells (Human hepatocellular liver carcinomacell line), using gold nanoparticles combuned with a specific growth factor and demonstrate its selective therapeutic efficacy usig ex vivo specimens. Ex vivo-perfused liver specimens were obtained from hepatocellular carcinoma patients similarly to the surgical technique of transplantation. Ab bound to GNPs was inoculated intra-arterially onto the resulting specimen and determined the specific delivery of the nano-bioconjugate into the malignant tissue by means of the capillary bed. The extent of necrosis was considerable following laser therapy and at the same time surrounding parenchyma was not seriously affected. The selective photothermal ablation of the malignant liver tissue was obtained after the selective accumulation of Ab bound to GNPs into tumor cells following ex-vivo intravascular perfusion. These unique results may represent a major step in liver cancer treatment using nanolocalized thermal ablation by laser heating.

Keywords: HepG2 cells, gold nanoparticles, nanoparticle functionalization, laser irradiation

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4454 Electrochemotherapy of Portal Vein Tumor Thrombus as Dowstaging to Liver Transplantation

Authors: Luciano Tarantino, Emanuele Balzano, Paolo Tarantino, Riccardo Aurelio Nasto, Aurelio Nasto

Abstract:

Liver transplantation (OLT) is contraindicate in Portal Vein tumor Thrombosis (PVTT) from Hepatocellular Carcinoma at hepatic hilum(pH-HCC) Surgery,Thermal ablation and chemotherapy show poorer outcomes Electrochemotherapy (ECT) has been successfully used in patients with pH-HCC with PVTT. We report the results of ECT as downstaging aimed to definitive cure by OLT. F.P. 53 years HBV related Cirrhosis Child-Pugh B7 class; EGDS F2 aesophageal Varices. Diabetes. April 2016 : Enhanced Computed Tomography (CT) detected HCC(n.3 nodules in VII-VIII-VI;diameter range=25 cm) and PVTT of right portal vein. The patient was considered ineligible for OLT. May 2016: first ablation session with percutaneous Radiofrequency-ablation(RFA) of 3 HCC-nodules . August 2016: second ablation session with ECT of PVTT. CT october 2016: disappearance of PVTT and patent right portal vein. No intraparenchymal recurrence. CT march 2017: No recurrence in portal vein and in the left lobe. local recurrence in the VII-VIII segments. May 2017 : transarterial chemoembolization (TACE) of right lobe recurrences. CT October 2017: patent right portal vein. No recurrence. The patient was reconsidered for OLT. He underwent OLT in April 2018. At 36-months follow-up , no intrahepatic recurrence of HCC occurred. March 2021: enhanced CT and PET/CT detected a single small nodule (1.5 cm) uptaking tracer in the left upper pulmonary lobe, no hepatic recurrence . CT-guided FNB showed metastasis from HCC . June 2021: left lung upper lobectomy . At the current time the patient is alive and recurrence-free at 64 months follow-up. ECT Could be aneffective technique as pre-OLT dowstaging in HCC with PVTT.

Keywords: liver tumor ablation, interventional ultrasound, electrochemotherapy, liver transplantation

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4453 Randomized, Controlled Blind Study Comparing Sacroiliac Intra-Articular Steroid Injection to Radiofrequency Denervation for Management of Sacroiliac Joint Pain

Authors: Ossama Salman

Abstract:

Background and objective: Sacroiliac joint pain is a common cause for chronic axial low back pain, with up to 20% prevalence rate. To date, no effective long-term treatment intervention has been embarked on yet. The aim of our study was to compare steroid block to radiofrequency ablation for SIJ pain conditions. Methods: A randomized, blind, study was conducted in 30 patients with sacroiliac joint pain. Fifteen patients received radiofrequency denervation of L4-5 primary dorsal rami and S1-3 lateral sacral branch, and 15 patients received steroid under fluoroscopy. Those in the steroid group who did not respond to steroid injections were offered to cross over to get radiofrequency ablation. Results: At 1-, 3- and 6-months post-intervention, 73%, 60% and 53% of patients, respectively, gained ≥ 50 % pain relief in the radiofrequency (RF) ablation group. In the steroid group, at one month post intervention follow up, only 20% gained ≥ 50 % pain relief, but failed to show any improvement at 3 months and 6 months follow up. Conclusions: Radiofrequency ablation at L4 and L5 primary dorsal rami and S1-3 lateral sacral branch may provide effective and longer pain relief compared to the classic intra-articular steroid injection, in properly selected patients with suspected sacroiliac joint pain. Larger studies are called for to confirm our results and lay out the optimal patient selection and treatment parameters for this poorly comprehended disorder.

Keywords: lateral branch denervation, LBD, radio frequency, RF, sacroiliac joint, SIJ, visual analogue scale, VAS

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4452 Data Modeling and Calibration of In-Line Pultrusion and Laser Ablation Machine Processes

Authors: David F. Nettleton, Christian Wasiak, Jonas Dorissen, David Gillen, Alexandr Tretyak, Elodie Bugnicourt, Alejandro Rosales

Abstract:

In this work, preliminary results are given for the modeling and calibration of two inline processes, pultrusion, and laser ablation, using machine learning techniques. The end product of the processes is the core of a medical guidewire, manufactured to comply with a user specification of diameter and flexibility. An ensemble approach is followed which requires training several models. Two state of the art machine learning algorithms are benchmarked: Kernel Recursive Least Squares (KRLS) and Support Vector Regression (SVR). The final objective is to build a precise digital model of the pultrusion and laser ablation process in order to calibrate the resulting diameter and flexibility of a medical guidewire, which is the end product while taking into account the friction on the forming die. The result is an ensemble of models, whose output is within a strict required tolerance and which covers the required range of diameter and flexibility of the guidewire end product. The modeling and automatic calibration of complex in-line industrial processes is a key aspect of the Industry 4.0 movement for cyber-physical systems.

Keywords: calibration, data modeling, industrial processes, machine learning

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4451 Comparison of Two Strategies in Thoracoscopic Ablation of Atrial Fibrillation

Authors: Alexander Zotov, Ilkin Osmanov, Emil Sakharov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

Abstract:

Objective: Thoracoscopic surgical ablation of atrial fibrillation (AF) includes two technologies in performing of operation. 1st strategy used is the AtriCure device (bipolar, nonirrigated, non clamping), 2nd strategy is- the Medtronic device (bipolar, irrigated, clamping). The study presents a comparative analysis of clinical outcomes of two strategies in thoracoscopic ablation of AF using AtriCure vs. Medtronic devices. Methods: In 2 center study, 123 patients underwent thoracoscopic ablation of AF for the period from 2016 to 2020. Patients were divided into two groups. The first group is represented by patients who applied the AtriCure device (N=63), and the second group is - the Medtronic device (N=60), respectively. Patients were comparable in age, gender, and initial severity of the condition. Among the patients, in group 1 were 65% males with a median age of 57 years, while in group 2 – 75% and 60 years, respectively. Group 1 included patients with paroxysmal form -14,3%, persistent form - 68,3%, long-standing persistent form – 17,5%, group 2 – 13,3%, 13,3% and 73,3% respectively. Median ejection fraction and indexed left atrial volume amounted in group 1 – 63% and 40,6 ml/m2, in group 2 - 56% and 40,5 ml/m2. In addition, group 1 consisted of 39,7% patients with chronic heart failure (NYHA Class II) and 4,8% with chronic heart failure (NYHA Class III), when in group 2 – 45% and 6,7%, respectively. Follow-up consisted of laboratory tests, chest Х-ray, ECG, 24-hour Holter monitor, and cardiopulmonary exercise test. Duration of freedom from AF, distant mortality rate, and prevalence of cerebrovascular events were compared between the two groups. Results: Exit block was achieved in all patients. According to the Clavien-Dindo classification of surgical complications fraction of adverse events was 14,3% and 16,7% (1st group and 2nd group, respectively). Mean follow-up period in the 1st group was 50,4 (31,8; 64,8) months, in 2nd group - 30,5 (14,1; 37,5) months (P=0,0001). In group 1 - total freedom of AF was in 73,3% of patients, among which 25% had additional antiarrhythmic drugs (AADs) therapy or catheter ablation (CA), in group 2 – 90% and 18,3%, respectively (for total freedom of AF P<0,02). At follow-up, the distant mortality rate in the 1st group was – 4,8%, and in the 2nd – no fatal events. Prevalence of cerebrovascular events was higher in the 1st group than in the 2nd (6,7% vs. 1,7% respectively). Conclusions: Despite the relatively shorter follow-up of the 2nd group in the study, applying the strategy using the Medtronic device showed quite encouraging results. Further research is needed to evaluate the effectiveness of this strategy in the long-term period.

Keywords: atrial fibrillation, clamping, ablation, thoracoscopic surgery

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4450 Endometrial Ablation and Resection Versus Hysterectomy for Heavy Menstrual Bleeding: A Systematic Review and Meta-Analysis of Effectiveness and Complications

Authors: Iliana Georganta, Clare Deehan, Marysia Thomson, Miriam McDonald, Kerrie McNulty, Anna Strachan, Elizabeth Anderson, Alyaa Mostafa

Abstract:

Context: A meta-analysis of randomized controlled trials (RCTs) comparing hysterectomy versus endometrial ablation and resection in the management of heavy menstrual bleeding. Objective: To evaluate the clinical efficacy, satisfaction rates and adverse events of hysterectomy compared to more minimally invasive techniques in the treatment of HMB. Evidence Acquisition: A literature search was performed for all RCTs and quasi-RCTs comparing hysterectomy with either endometrial ablation endometrial resection of both. The search had no language restrictions and was last updated in June 2020 using MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, PubMed, Google Scholar, PsycINFO, Clinicaltrials.gov and Clinical trials. EU. In addition, a manual search of the abstract databases of the European Haemophilia Conference on women's health was performed and further studies were identified from references of acquired papers. The primary outcomes were patient-reported and objective reduction in heavy menstrual bleeding up to 2 years and after 2 years. Secondary outcomes included satisfaction rates, pain, adverse events short and long term, quality of life and sexual function, further surgery, duration of surgery and hospital stay and time to return to work and normal activities. Data were analysed using RevMan software. Evidence synthesis: 12 studies and a total of 2028 women were included (hysterectomy: n = 977 women vs endometrial ablation or resection: n = 1051 women). Hysterectomy was compared with endometrial ablation only in five studies (Lin, Dickersin, Sesti, Jain, Cooper) and endometrial resection only in five studies (Gannon, Schulpher, O’Connor, Crosignani, Zupi) and a mixture of the Ablation and Resection in two studies (Elmantwe, Pinion). Of the 1² studies, 10 reported women’s perception of bleeding symptoms as improved. Meta-analysis showed that women in the hysterectomy group were more likely to show improvement in bleeding symptoms when compared with endometrial ablation or resection up to 2-year follow-up (RR 0.75, 95% CI 0.71 to 0.79, I² = 95%). Objective outcomes of improvement in bleeding also favored hysterectomy. Patient satisfaction was higher after hysterectomy within the 2 years follow-up (RR: 0.90, 95%CI: 0.86 to 0.94, I²:58%), however, there was no significant difference between the two groups at more than 2 years follow up. Sepsis (RR: 0.03, 95% CI 0.002 to 0.56; 1 study), wound infection (RR: 0.05, 95% CI: 0.01 to 0.28, I²: 0%, 3 studies) and Urinary tract infection (UTI) (RR: 0.20, 95% CI: 0.10 to 0.42, I²: 0%, 4 studies) all favoured hysteroscopic techniques. Fluid overload (RR: 7.80, 95% CI: 2.16 to 28.16, I² :0%, 4 studies) and perforation (RR: 5.42, 95% CI: 1.25 to 23.45, I²: 0%, 4 studies) however favoured hysterectomy in the short term. Conclusions: This meta-analysis has demonstrated that endometrial ablation and endometrial resection are both viable options when compared with hysterectomy for the treatment of heavy menstrual bleeding. Hysteroscopic procedures had better outcomes in the short term with fewer adverse events including wound infection, UTI and sepsis. The hysterectomy performed better when measuring more long-term impacts such as recurrence of symptoms, overall satisfaction at two years and the need for further treatment or surgery.

Keywords: menorrhagia, hysterectomy, ablation, resection

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4449 Alcohol Septal Ablation in a 19-Year-Old with Hypertrophic Obstructive Cardiomyopathy Patient: A Case Report

Authors: Christine Ysabelle G. Roman, Pauline Torres

Abstract:

Background: Hypertrophic cardiomyopathy is a disease of marked heterogeneity. It is a genetically determined heart disease characterized by significant myocardium hypertrophy that results in diastolic dysfunction, left ventricular outflow tract obstruction, and an increased risk of arrhythmias. The primary treatment in patients with such conditions is negative inotropic drugs, such as beta-blockers, calcium channel antagonists, and disopyramide. However, for those who remain symptomatic and need septal reduction therapy, surgical septal myectomy or alcohol septal ablation are options. Case Summary: A 19 – year old female presented in the authors’ institution with easy fatigability. The consult was done a year prior, and 2D echocardiography was requested which showed concentric left ventricular hypertrophy, asymmetrically hypertrophied interventricular septum (IVS) with the largest diameter of 3.3cm & subaortic dynamic obstruction with a maximum gradient of 47 mmHg. A repeat echo a year later showed asymmetric septal hypertrophy (IVS measuring at 3cm) with the systolic anterior motion of anterior mitral valve leaflet and left ventricular outflow tract obstruction (peak gradient of 50mmHg). The patient then underwent alcohol septal ablation and was discharged stable after four days of admission. Conclusion: Hypertrophic obstructive cardiomyopathy, a cardiovascular genetic disease, results in various patterns of left ventricular hypertrophy and abnormality of mitral valve apparatus. The patient is managed medically initially. However, despite optimal drug therapy and significant left ventricular outflow tract obstruction, significant heart failure symptoms or syncope require invasive treatment.

Keywords: hypertrophic obstructive cardiomyopathy, left ventricular outflow tract obstruction, alcohol septal ablation, alcohol

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4448 Hydro-Chemical Characterization of Glacial Melt Waters Draining from Shaune Garang Glacier, Himachal Himalaya

Authors: Ramesh Kumar, Rajesh Kumar, Shaktiman Singh, Atar Singh, Anshuman Bhardwaj, Ravindra Kumar Sinha, Anupma Kumari

Abstract:

A detailed study of the ion chemistry of the Shaune Garnag glacier meltwater has been carried out to assess the role of active glacier in the chemical denudation rate. The chemical compositions of various ions in meltwater of the Shaune Garang glacier were analyzed during the melting period 2015 and 2016. Total 112 of melt water samples twice in a day were collected during ablation season of 2015 and 2016. To identify various factors controlling the dissolved ionic strength of Shaune Garang Glacier meltwater statistical analysis such as correlation matrix, Principle Component Analysis (PCA) and factor analysis were applied to deduce the result. Cation concentration for Ca²⁺ > Mg²⁺ > Na⁺ > K⁺ in the meltwater for both the years can be arranged in the order as Ca²⁺ > Mg²⁺ > Na⁺ > K⁺. Study showed that Ca²⁺ and HCO₃⁻ found to be dominant on the both melting period. Carbonate weathering identified as the dominant process controlling the dissolved ion chemistry of meltwater due to the high ratios of (Ca²⁺ + Mg²⁺) versus TZ+ and (Ca²⁺ + Mg²⁺) versus (Na⁺ + K⁺) in the study area. The cation denudation rate of the Shaune Garnag catchment is 3412.2 m⁻² a⁻¹, i.e. higher than the other glacierised catchment in the Himalaya, indicating intense chemical erosion in this catchment.

Keywords: Shaune Garang glacier, Hydrochemistry, chemical composition, cation denudation rate, carbonate weathering

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4447 Added Value of 3D Ultrasound Image Guided Hepatic Interventions by X Matrix Technology

Authors: Ahmed Abdel Sattar Khalil, Hazem Omar

Abstract:

Background: Image-guided hepatic interventions are integral to the management of infective and neoplastic liver lesions. Over the past decades, 2D ultrasound was used for guidance of hepatic interventions; with the recent advances in ultrasound technology, 3D ultrasound was used to guide hepatic interventions. The aim of this study was to illustrate the added value of 3D image guided hepatic interventions by x matrix technology. Patients and Methods: This prospective study was performed on 100 patients who were divided into two groups; group A included 50 patients who were managed by 2D ultrasonography probe guidance, and group B included 50 patients who were managed by 3D X matrix ultrasonography probe guidance. Thermal ablation was done for 70 patients, 40 RFA (20 by the 2D probe and 20 by the 3D x matrix probe), and 30 MWA (15 by the 2D probe and 15 by the 3D x matrix probe). Chemical ablation (PEI) was done on 20 patients (10 by the 2D probe and 10 by the 3D x matrix probe). Drainage of hepatic collections and biopsy from undiagnosed hepatic focal lesions was done on 10 patients (5 by the 2D probe and 5 by the 3D x matrix probe). Results: The efficacy of ultrasonography-guided hepatic interventions by 3D x matrix probe was higher than the 2D probe but not significantly higher, with a p-value of 0.705, 0.5428 for RFA, MWA respectively, 0.5312 for PEI, 0.2918 for drainage of hepatic collections and biopsy. The complications related to the use of the 3D X matrix probe were significantly lower than the 2D probe, with a p-value of 0.003. The timing of the procedure was shorter by the usage of 3D x matrix probe in comparison to the 2D probe with a p-value of 0.08,0.34 for RFA and PEI and significantly shorter for MWA, and drainage of hepatic collection, biopsy with a P-value of 0.02,0.001 respectively. Conclusions: 3D ultrasonography-guided hepatic interventions by  x matrix probe have better efficacy, less complication, and shorter time of procedure than the 2D ultrasonography-guided hepatic interventions.

Keywords: 3D, X matrix, 2D, ultrasonography, MWA, RFA, PEI, drainage of hepatic collections, biopsy

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4446 Development of a Very High Sensitivity Magnetic Field Sensor Based on Planar Hall Effect

Authors: Arnab Roy, P. S. Anil Kumar

Abstract:

Hall bar magnetic field sensors based on planar hall effect were fabricated from permalloy (Ni¬80Fe20) thin films grown by pulsed laser ablation. As large as 400% planar Hall voltage change was observed for a magnetic field sweep within ±4 Oe, a value comparable with present day TMR sensors at room temperature. A very large planar Hall sensitivity of 1200 Ω/T was measured close to switching fields, which was not obtained so far apart from 2DEG Hall sensors. In summary, a highly sensitive low magnetic field sensor has been constructed which has the added advantage of simple architecture, good signal to noise ratio and robustness.

Keywords: planar hall effect, permalloy, NiFe, pulsed laser ablation, low magnetic field sensor, high sensitivity magnetic field sensor

Procedia PDF Downloads 489
4445 A Reduced Ablation Model for Laser Cutting and Laser Drilling

Authors: Torsten Hermanns, Thoufik Al Khawli, Wolfgang Schulz

Abstract:

In laser cutting as well as in long pulsed laser drilling of metals, it can be demonstrated that the ablation shape (the shape of cut faces respectively the hole shape) that is formed approaches a so-called asymptotic shape such that it changes only slightly or not at all with further irradiation. These findings are already known from the ultrashort pulse (USP) ablation of dielectric and semiconducting materials. The explanation for the occurrence of an asymptotic shape in laser cutting and long pulse drilling of metals is identified, its underlying mechanism numerically implemented, tested and clearly confirmed by comparison with experimental data. In detail, there now is a model that allows the simulation of the temporal (pulse-resolved) evolution of the hole shape in laser drilling as well as the final (asymptotic) shape of the cut faces in laser cutting. This simulation especially requires much less in the way of resources, such that it can even run on common desktop PCs or laptops. Individual parameters can be adjusted using sliders – the simulation result appears in an adjacent window and changes in real time. This is made possible by an application-specific reduction of the underlying ablation model. Because this reduction dramatically decreases the complexity of calculation, it produces a result much more quickly. This means that the simulation can be carried out directly at the laser machine. Time-intensive experiments can be reduced and set-up processes can be completed much faster. The high speed of simulation also opens up a range of entirely different options, such as metamodeling. Suitable for complex applications with many parameters, metamodeling involves generating high-dimensional data sets with the parameters and several evaluation criteria for process and product quality. These sets can then be used to create individual process maps that show the dependency of individual parameter pairs. This advanced simulation makes it possible to find global and local extreme values through mathematical manipulation. Such simultaneous optimization of multiple parameters is scarcely possible by experimental means. This means that new methods in manufacturing such as self-optimization can be executed much faster. However, the software’s potential does not stop there; time-intensive calculations exist in many areas of industry. In laser welding or laser additive manufacturing, for example, the simulation of thermal induced residual stresses still uses up considerable computing capacity or is even not possible. Transferring the principle of reduced models promises substantial savings there, too.

Keywords: asymptotic ablation shape, interactive process simulation, laser drilling, laser cutting, metamodeling, reduced modeling

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4444 Thermodynamic and Immunochemical Studies of Antibody Biofunctionalized Gold Nanoparticles Mediated Photothermal Ablation in Human Liver Cancer Cells

Authors: Lucian Mocan, Flaviu Tabaran, Teodora Mocan, Cristian Matea, Cornel Iancu

Abstract:

We present method of Gold Nanoparticle enhanced laser thermal ablation of HepG2 cells (Human hepatocellular liver carcinoma cell line), based on a simple gold nanoparticle carrier system, such as serum albumin (BSA), and demonstrate its selective therapeutic efficacy. Hyperspectral, contrast phase, and confocal microscopy combined immunochemical staining were used to demonstrate the selective internalization of HSA-GNPs via Gp60 receptors and the caveolin-mediated endocytosis inside HepG2 cells. We examined the ability of laser-activated carbon nanotubes to induce Hsp70 expression using confocal microscopy. Hep G2 cells heat-shocked (laser activated BSA-GNPs) to 42°C demonstrated an up-regulation of Hsp70 compared with control cells (BSA-GNPs treated cells without laser), which showed no detectable constitutive expression of Hsp70. We observed a time-dependent induction in Hsp70 expression in Hep G2 treated with BSA-GNPs and LASER irradiated. The post-irradiation apoptotic rate of HepG2 cells treated with HSA-GNPs ranged from 88.24% (for 50 mg/L) at 60 seconds, while at 30 minute the rate increased to 92.34% (50 mg/L). These unique results may represent a major step in liver cancer treatment using nanolocalized thermal ablation by laser heating.

Keywords: gold nanoparticles, liver cancer, albumin, laser irradiation

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4443 Low- and High-Temperature Methods of CNTs Synthesis for Medicine

Authors: Grzegorz Raniszewski, Zbigniew Kolacinski, Lukasz Szymanski, Slawomir Wiak, Lukasz Pietrzak, Dariusz Koza

Abstract:

One of the most promising area for carbon nanotubes (CNTs) application is medicine. One of the most devastating diseases is cancer. Carbon nanotubes may be used as carriers of a slowly released drug. It is possible to use of electromagnetic waves to destroy cancer cells by the carbon nanotubes (CNTs). In our research we focused on thermal ablation by ferromagnetic carbon nanotubes (Fe-CNTs). In the cancer cell hyperthermia functionalized carbon nanotubes are exposed to radio frequency electromagnetic field. Properly functionalized Fe-CNTs join the cancer cells. Heat generated in nanoparticles connected to nanotubes warm up nanotubes and then the target tissue. When the temperature in tumor tissue exceeds 316 K the necrosis of cancer cells may be observed. Several techniques can be used for Fe-CNTs synthesis. In our work, we use high-temperature methods where arc-discharge is applied. Low-temperature systems are microwave plasma with assisted chemical vapor deposition (MPCVD) and hybrid physical-chemical vapor deposition (HPCVD). In the arc discharge system, the plasma reactor works with a pressure of He up to 0,5 atm. The electric arc burns between two graphite rods. Vapors of carbon move from the anode, through a short arc column and forms CNTs which can be collected either from the reactor walls or cathode deposit. This method is suitable for the production of multi-wall and single-wall CNTs. A disadvantage of high-temperature methods is a low purification, short length, random size and multi-directional distribution. In MPCVD system plasma is generated in waveguide connected to the microwave generator. Then containing carbon and ferromagnetic elements plasma flux go to the quartz tube. The additional resistance heating can be applied to increase the reaction effectiveness and efficiency. CNTs nucleation occurs on the quartz tube walls. It is also possible to use substrates to improve carbon nanotubes growth. HPCVD system involves both chemical decomposition of carbon containing gases and vaporization of a solid or liquid source of catalyst. In this system, a tube furnace is applied. A mixture of working and carbon-containing gases go through the quartz tube placed inside the furnace. As a catalyst ferrocene vapors can be used. Fe-CNTs may be collected then either from the quartz tube walls or on the substrates. Low-temperature methods are characterized by higher purity product. Moreover, carbon nanotubes from tested CVD systems were partially filled with the iron. Regardless of the method of Fe-CNTs synthesis the final product always needs to be purified for applications in medicine. The simplest method of purification is an oxidation of the amorphous carbon. Carbon nanotubes dedicated for cancer cell thermal ablation need to be additionally treated by acids for defects amplification on the CNTs surface what facilitates biofunctionalization. Application of ferromagnetic nanotubes for cancer treatment is a promising method of fighting with cancer for the next decade. Acknowledgment: The research work has been financed from the budget of science as a research project No. PBS2/A5/31/2013

Keywords: arc discharge, cancer, carbon nanotubes, CVD, thermal ablation

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4442 Macroscopic Support Structure Design for the Tool-Free Support Removal of Laser Powder Bed Fusion-Manufactured Parts Made of AlSi10Mg

Authors: Tobias Schmithuesen, Johannes Henrich Schleifenbaum

Abstract:

The additive manufacturing process laser powder bed fusion offers many advantages over conventional manufacturing processes. For example, almost any complex part can be produced, such as topologically optimized lightweight parts, which would be inconceivable with conventional manufacturing processes. A major challenge posed by the LPBF process, however, is, in most cases, the need to use and remove support structures on critically inclined part surfaces (α < 45 ° regarding substrate plate). These are mainly used for dimensionally accurate mapping of part contours and to reduce distortion by absorbing process-related internal stresses. Furthermore, they serve to transfer the process heat to the substrate plate and are, therefore, indispensable for the LPBF process. A major challenge for the economical use of the LPBF process in industrial process chains is currently still the high manual effort involved in removing support structures. According to the state of the art (SoA), the parts are usually treated by simple hand tools (e.g., pliers, chisels) or by machining (e.g., milling, turning). New automatable approaches are the removal of support structures by means of wet chemical ablation and thermal deburring. According to the state of the art, the support structures are essentially adapted to the LPBF process and not to potential post-processing steps. The aim of this study is the determination of support structure designs that are adapted to the mentioned post-processing approaches. In the first step, the essential boundary conditions for complete removal by means of the respective approaches are identified. Afterward, a representative demonstrator part with various macroscopic support structure designs will be LPBF-manufactured and tested with regard to a complete powder and support removability. Finally, based on the results, potentially suitable support structure designs for the respective approaches will be derived. The investigations are carried out on the example of the aluminum alloy AlSi10Mg.

Keywords: additive manufacturing, laser powder bed fusion, laser beam melting, selective laser melting, post processing, tool-free, wet chemical ablation, thermal deburring, aluminum alloy, AlSi10Mg

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4441 Fabrication of Carbon Nanoparticles and Graphene Using Pulsed Laser Ablation

Authors: Davoud Dorranian, Hajar Sadeghi, Elmira Solati

Abstract:

Carbon nanostructures in various forms were synthesized using pulsed laser ablation of a graphite target in different liquid environment. The beam of a Q-switched Nd:YAG laser of 1064-nm wavelength at 7-ns pulse width is employed to irradiate the solid target in water, acetone, alcohol, and cetyltrimethylammonium bromide (CTAB). Then the effect of the liquid environment on the characteristic of carbon nanostructures produced by laser ablation was investigated. The optical properties of the carbon nanostructures were examined at room temperature by UV–Vis-NIR spectrophotometer. The crystalline structure of the carbon nanostructures was analyzed by X-ray diffraction (XRD). The morphology of samples was investigated by field emission scanning electron microscope (FE-SEM). Transmission electron microscope (TEM) was employed to investigate the form of carbon nanostructures. Raman spectroscopy was used to determine the quality of carbon nanostructures. Results show that different carbon nanostructures such as nanoparticles and few-layer graphene were formed in various liquid environments. The UV-Vis-NIR absorption spectra of samples reveal that the intensity of absorption peak of nanoparticles in alcohol is higher than the other liquid environments due to the larger number of nanoparticles in this environment. The red shift of the absorption peak of the sample in acetone confirms that produced carbon nanoparticles in this liquid are averagely larger than the other medium. The difference in the intensity and shape of the absorption peak indicated the effect of the liquid environment in producing the nanoparticles. The XRD pattern of the sample in water indicates an amorphous structure due to existence the graphene sheets. X-ray diffraction pattern shows that the degree of crystallinity of sample produced in CTAB is higher than the other liquid environments. Transmission electron microscopy images reveal that the generated carbon materials in water are graphene sheet and in the other liquid environments are graphene sheet and spherical nanostructures. According to the TEM images, we have the larger amount of carbon nanoparticles in the alcohol environment. FE-SEM micrographs indicate that in this liquids sheet like structures are formed however in acetone, produced sheets are adhered and these layers overlap with each other. According to the FE-SEM micrographs, the surface morphology of the sample in CTAB was coarser than that without surfactant. From Raman spectra, it can be concluded the distinct shape, width, and position of the graphene peaks and corresponding graphite source.

Keywords: carbon nanostructures, graphene, pulsed laser ablation, graphite

Procedia PDF Downloads 286
4440 Interaction between Unsteady Supersonic Jet and Vortex Rings

Authors: Kazumasa Kitazono, Hiroshi Fukuoka, Nao Kuniyoshi, Minoru Yaga, Eri Ueno, Naoaki Fukuda, Toshio Takiya

Abstract:

The unsteady supersonic jet formed by a shock tube with a small high-pressure chamber was used as a simple alternative model for pulsed laser ablation. Understanding the vortex ring formed by the shock wave is crucial in clarifying the behavior of unsteady supersonic jet discharged from an elliptical cell. Therefore, this study investigated the behavior of vortex rings and a jet. The experiment and numerical calculation were conducted using the schlieren method and by solving the axisymmetric two-dimensional compressible Navier–Stokes equations, respectively. In both, the calculation and the experiment, laser ablation is conducted for a certain duration, followed by discharge through the exit. Moreover, a parametric study was performed to demonstrate the effect of pressure ratio on the interaction among vortex rings and the supersonic jet. The interaction between the supersonic jet and the vortex rings increased the velocity of the supersonic jet up to the magnitude of the velocity at the center of the vortex rings. The interaction between the vortex rings increased the velocity at the center of the vortex ring.

Keywords: computational fluid dynamics, shock-wave, unsteady jet, vortex ring

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4439 Radiofrequency Ablation: A Technique in the Management of Low Anal Fistula

Authors: R. Suresh, C. B. Singh, A. K. Sarda

Abstract:

Background: Over the decades, several surgical techniques have been developed to treat anal fistulas with variable success rates and complications. Large amount of work has been done in radiofrequency excision of the fistula for several years but no work has been done for ablating the tract. Therefore one can consider for obliteration ofanal fistula by Radiofrequency ablation (RFA). Material and Methods: A randomized controlled clinical trial was conducted at Lok Nayak Hospital, where a total of 40 patients were enrolled in the study and they were randomly assigned to Group I (fistulectomy)(n=20) and Group II (RFA) (n=20). Aim of the study was to compare the efficacy of RFA of fistula versus fistulectomy in the treatment of a low anal fistula and to evaluate RFA as an effective alternative to fistulectomy with respect to time taken for wound healing as primary outcome and post-operative pain, time taken to return to work as secondary outcomes. Patients with simple low anal fistulas, single internal and external opening, not more than two secondary tracts were included. Patients with high complex fistula, fistulas communicating with cavity, fistula due to condition like tuberculosis, Crohn's, malignancy were excluded from the study. Results: Both groups were comparable with respect to age, sex ratio, type of fistula. Themean healing time was significantly shorter in group II (41.02 days) than in group I(62.68 days).The mean operative time was significantly shorter in groupII (21.40 min) than in group I(28.50 min). The mean time taken to return to work was significantly shorter in group II(8.30 days)than in group I(12.01 days).There was no significant difference in the post operative hospital stay, mean postoperative pain score, wound infection and recurrence between the two groups. Conclusion: The patients who underwent RFA of fistula had shorter wound healing time, operative time and time taken to return to work when compared to those who underwent fistulectomy and therefore RFA shows outcome comparable to fistulectomy in the treatment of low anal fistula.

Keywords: fistulectomy, low anal fistula, radio frequency ablation, wound healing

Procedia PDF Downloads 317