The following information was presented at the 2005 European Respiratory Society Annual Congress by Franz Stanzel, Peter Raasch and Karl Haeussinger.

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Airway recanalization in advanced cancers is one of the intervetional procedures of daily routine nowadays. Beside the Nd:YAG laser electrocoagulation and especially APC are widespread. Coagulation and hemostasis seem to be sometimes only suboptimal. A new 2 continuous wave DPSS laser (Revolix ) combines cutting and ablation advantages and achieves excellent hemostasis.

We carried out a pilot sudy in 23 patients (15 male, 8 female) suffering from lung cancer (19), typical carcinoid (3), or lipoma (1) with central airway obstruction and retention pneumonia. All patients had total or subtotal obstruction of the trachea (5), main stem bronchi (15) or lobar bronchi (10). We used the Revolix for ablation of obstructing tumour masses in 35 bronchoscopies. The power setting was 5 - 15 W, pulsed or continuous, by flexible bare terminated or compressed air cooled fibres.

In 20 out of 23 patients airway patency could be established. In 3 cases the stenosis was too long exceeding to the subsegmental level. Ablation was faster, hemostasis more effective, and power was lower compared to the Nd:YAG laser. There was no need of changing to Nd:YAG or APC. We recommend the cooled fibre because of a risk of fire when using the bare fibre. We saw no patient complications, but one bronchoscope damage (coagulation of the tip).

The Revolix is a very effective and fast tool for airway recanalization. It is safe when the cooled fibre is used. It may replace the Nd:YAG laser because of the better hemostasis and the better calculable tissue effect.