MIT MRSEC Michael F. Rubner DMR-0213282 First Minimally-Invasive Human Laser Surgery Using

A Cylindrical Photonic Bandgap Fiber (Omniguide)

The first minimally-invasive procedure in a patient using a polymeric cylindrical photonic bandgap fiber (OmniGuide) to deliver CO2 laser energy at a wavelength of 10.6 microns was performed on Friday November 19th 2004. The procedure was performed by Dr. Jamie Koufman, the director of the Center for Voice and Swallowing Disorders of Wake Forest University at the Voice Center in Winston-Salem, North Carolina.

The patient, who was diagnosed with recurrent respiratory papillomas (RRP), suffered from near-total obstruction of the larynx (voice box) and trachea (the breathing tube that joins the throat and the lung). The patient’s growths in the larynx and trachea were cleared using a CO2 laser delivered endoscopically with an OmniGuide Fiber. The patient was awake during the procedure. Other than spraying a numbing spray in the throat and trachea, the patient required no anesthesia. CO2 lasers have been used to treat RRP for many years. In the past, these procedures could only be performed in the operating room, with the patient under general anesthesia. The OmniGuide Fiber allows use of the same CO2 laser technology, but in a clinic setting instead of in the operating room. With the OmniGuide Fiber used to deliver the laser energy through a flexible Pentax endoscope, the patient treated by Dr. Koufman was able to go home immediately following the procedure.

Dr. Koufman pioneered work in laryngeal laser surgery, laryngopharyngeal reflux, laryngeal electromyography, laryngoplastic phonosurgery, and other forms of laryngeal (voice) rehabilitation surgery. She has won the Casselberry Award of the American Laryngological Association and the Broyles-Maloney Award of the American Broncho-Esophagological Association. She has published more than 100 peer-reviewed scientific articles and book chapters, and she has lectured extensively nationally and internationally.

Dr. Jamie Koufman said, “Unsedated, laryngeal laser surgery with the OmniGuide Fiber and the new Pentax optical scopes is a dream come true for me as an endoscopic surgeon, and the patient who had this surgery loved it because it was easy for her.” She added, “OmniGuide has introduced a cutting-edge technology that will push out-patient laryngeal surgery to a new level; and, by moving most of laryngeal surgery out of the operating room and into the clinic, the cost savings per procedure will be measured in the tens of thousands of dollars, and the national cost savings will be huge.”The polymeric photonic bandgap fiber used in this procedure is based on the work of an MIT graduate student Shandon Hart an NSF Graduate Fellowship recipient (PhD 2004) and was first published in Nature 420, 650-653 (2002). The technology was subsequently licensed to OmniGuide Communications in 2003. The fundamental research behind this new technology was funded by the NSF supported MIT MRSEC program.