Laser Surgery Health Article

Definition

Laser is an acronym that stands for Light Amplification by Stimulated Emission of Radiation. Laser surgery uses an intensely hot, precisely focused beam of light to remove or vaporize tissue and control bleeding in a wide variety of noninvasive and minimally invasive procedures.

Purpose

Laser surgery may be used to:

• cut or destroy tissue that is abnormal or diseased without harming healthy, normal tissue
• shrink or destroy tumors and lesions
• cauterize (seal) blood vessels to prevent excessive bleeding

Precautions

Although many laser surgeries can be performed in the physician's office rather than in a hospital, practitioners must be at least as thoroughly trained and highly skilled their counterparts in a hospital setting. The American Society for Laser Medicine and Surgery, Inc. recommends that:

• All operative areas be equipped with oxygen and other drugs and equipment required for cardiopulmonary resuscitation (CPR).
• Nonphysicians performing laser procedures be properly trained, licensed, and insured.
• A qualified and experienced supervising physician be able to respond to and manage unanticipated events or other emergencies within five minutes of the time they occur.
• Emergency transportation to a hospital or other acutecare facility be available whenever laser surgery is performed in a nonhospital setting.

All patients who are considering laser surgery should be fully informed about the procedure's relative risks and benefits, as well as any alternatives that may exist. Some types of laser surgery, for example, should not be performed on pregnant women or on patients with severe cardiopulmonary disease or other serious health problems. The patient should understand why laser surgery a better choice than traditional surgery (in this instance), and how much experience the physician has in performing the laser procedure the patient is considering. Generally, surgical nurses will inform patients about the planned procedure and, if hospital policy permits nurses to do so, obtain their informed consent to proceed; some hospitals require doctors to do this.

Description

The first working lasers were introduced in 1960. They were initially used to treat diseases and disorders of the eye, where transparent tissues gave ophthalmic surgeons a clear view of how the narrow, concentrated beam was being directed. Dermatologic surgeons helped further pioneer laser surgery, developing and improving many early techniques and refining surgical procedures.

Lasers are medically useful because they can be directed with pinpoint accuracy to cut, vaporize, or weld tissue while cauterizing blood vessels and nerves to reduce or eliminate surgical bleeding and postoperative pain. This reduces postoperative swelling and scarring as well as the length of the recovery period. A laser's heat often destroys bacteria and viruses in the surgical field, creating a more sterile environment that is less prone to infection. Because a smaller incision is required, laser procedures often take less time than traditional surgery. Lasers can also be tailored to particular applications.

All lasers operate on the principle of selective photothermolysis, meaning that the laser's wavelength, energy density, power, and exposure time determine what types of tissue will be affected and the effects that will be produced. Lasers can be further adapted to different medical procedures with special delivery (such as fiberoptic cables) that help apply the laser beam.

Laser applications

Sometimes described as "scalpels of light," lasers are used alone or with conventional surgical instruments and can be tailored with seemingly infinite precision for a vast number of surgical procedures. For these reasons laser surgery is often standard operating procedure for specialists in cardiology, dentistry, dermatology, gastroenterology, gynecology, neurosurgery, oncology, ophthalmology, orthopedics, otolaryngology, pulmonology, and urology.

Lasers are used to erase birthmarks, skin discolorations, and skin changes due to aging; to remove benign, precancerous, or cancerous tissues or tumors; to stop snoring; remove tonsils; remove or transplant hair; and relieve pain and restore function in patients too weak to undergo more invasive surgery. Lasers are also used to treat angina; cancerous or noncancerous tumors that cannot be removed or destroyed; cold and canker sores, gum disease and tooth sensitivity or decay; ectopic pregnancy, endometriosis, and fibroid tumors; gallstones; glaucoma, mild-to-moderate nearsightedness, astigmatism, and other conditions that impair vision; migraine headaches; noncancerous enlargement of the prostate gland; nosebleeds; ovarian cysts; ulcers; varicose veins; warts; and numerous other conditions, diseases, and disorders.