by
Andrea Alstad, Marketing & Communications Coord,
ASLMS | February 25, 2015
From the January/February 2015 issue of HealthCare Business News magazine
Applications of lasers in surgery
The earliest applications for lasers in surgery occurred in the areas of ophthalmology and dermatology. LASIK surgery is perhaps the most best known laser application in ophthalmology, but lasers are also used to treat detached retinas, glaucoma and diabetic retinopathy. The dermatological use of lasers and other energy-based devices spans from the vastly increasing applications for cosmetic procedures to the treatment of port-wine stains, melanomas and scars due to traumatic injury. Currently, the CO2, holmium, thulium, KTP, KDP, LBO, Nd:YAG, and high power diode laser technologies are available for use in soft tissue applications. Laser technology is also available for lithotripsy.
Common uses for surgical lasers include:
• Neurosurgery, with precision cutting and endoscopic guidance in the brain and spinal cord
• Urology – treatment of urinary stones, bladder obstructions and enlarged prostates
• Dental applications such as drilling cavities, gum surgery, antibacterial treatments and tooth decay detection with optical coherence technology OCT imaging
• Gastroenterology, for management of obstructing and bleeding tumors and vascular malformations
• Gynecology, for treatment of cysts, endometriosis and fibroid tumors
• Otolaryngology, for treatment of lesions of the nasal passages, paranasal sinuses, larynx, and trachea.
The photons from a CO2 laser can be carried via hollow tubes, waveguides and mirrors. The OmniGuide fiber is a flexible chalcogenide glass waveguide that has been utilized for otolaryngological and neurosurgical procedures. “The potential exists for broader clinical use including various general surgical procedures,” states Lanzafame.
“The laparoscopic use of this wavelength is possible with the use of a focusing cube and an operative laparoscope, or with a variety of waveguides designed for multi-puncturelaparoscopic applications. The OmniGuide overcomes some of the problems associated with free beam and rigid waveguides due to its small diameter and flexibility, which more emulates a true fiber. The availability of these highly flexible devices has resulted in resurgence in the use of carbon dioxide laser energy for neurosurgical and otolaryngologicalprocedures including microsurgical applications.”
Thulium laser technology has recently become available for use with the da Vinci Surgical Robotic System from Intuitive Surgical, using the RevoLix system from LISA Laser USA. The robotic platform is fitted with a flexible introducer that is capable of accepting up to a 5F (1.67mm) diameter fiber.
