Laser surgery is surgery using a laser (instead of a scalpel) to cut tissue. Examples include the use of a laser scalpel in otherwise conventional surgery, and soft tissue laser surgery, in which the laser beam vaporizes soft tissue with high water content. Laser resurfacing is a technique in which molecular bonds of a material are dissolved by a laser. Laser surgery is commonly used on the eye. Techniques used include LASIK, which is used to correct near and far-sightedness in vision, and photorefractive keratectomy, a procedure which permanently reshapes the cornea using an excimer laser to remove a small amount of tissue.[1][2][3]
Green laser surgery is used for the treatment/reduction of enlarged prostates. Laser surgery is much safer than normal surgery as it makes no physical contact so no infections are spread.
Types of surgical lasers include carbon dioxide, argon, Nd:YAG, and KTP.
[edit] Effects
- Photochemical effect: clinically referred to as photodynamic therapy. Photosensitizer (photophrin II) is administered which is taken up by the tumor tissue and later irradiated by laser light resulting in highly toxic substances with resultant necrosis of the tumor. Photodynamic therapy is used in palliation of oesophagial and bronchial carcinoma and ablation of mucosal cancers of Gastrointestinal tract and urinary bladder.
- Photoablative effect: Used in eye surgeries like band keratoplast, and endartectomy of peripheral blood vessels.
- Photothermal effect: this property is used for endoscopic control of bleeding e.g. Bleeding peptic ulcers, oesophagial varices
- Photomechanical effect: used in intraluminal lithotripsy
[edit] Applications
[edit] Gastro-intestinal tract
- Peritoneum - Laser is used for adhesiolysis.
- Peptic ulcer disease and oesophageal varices - Laser photoablation is done.
- Caogulation of Vascular malformations of stomach, duodenum and colon.
- Lasers can be effectively used to treat early gastric cancers provided they are less than 4 cm and without lymph node involvement. Lasers are also used in treating oral submucous fibrosis.
- Palliative laser therapy is given in advanced oesophageal cancers with obstruction of lumen. Recanalisation of the lumen is done which allows the patient to resume soft diet and maintain hydration.
- Photoablative laser therapy is used in advanced colorectal cancers to relieve obstruction and to control bleeding.
- Laser surgery used in hemorrhoidectomy, and is a relatively popular and non-invasive method of hemorrhoid removal.[4]
- Laser assisted resections with carbon dioxide laser and Nd:YAG laser have been used in liver resections
- Ablation of liver tumors can be achieved by selective photo vaporization of the tumor.
- Endoscopic laser lithotripsy is a safer modality compared to electro hydraulic lithotripsy.
[edit] Endovascular surgery
- Laser endarterectomy : It is a technique in which an entire atheromatous plaque in the artery is excised. Laser recanalization of blocked arteries. other applications include laser assisted angioplasties and laser assisted vascular anastamosis.
[edit] Healing properties
- Low energy lasers promote wound healing and relieve musculoskeletal pain.[citation needed]
[edit] References
- ^ Cuscheri et al.. "Essential Surgical Practice". Basic surgical training. (4 ed.). pp. 62–65.
- ^ Schwesinger, WH; Hunter, JG (1992). Laser in General Surgery. Surgical Clinics of North America.
- ^ Morris, Peter J; Wood, William C.. Oxford Textbook of Surgery. 2.
- ^ "Hemorrhoid Treatment". Hemorrhoid Relief. http://www.thehemorrhoidrelief.info/. Retrieved 23 January 2012.
