Laser Surgery Health Article

Definition

The term laser means light amplification by stimulated emission of radiation, and it uses a laser light source (laser beam) to remove tissues that are diseased or to treat blood vessels that are bleeding. Laser beams are strong beams of light produced by electrically stimulating a particular material. A solid, a liquid, or a gas is used. Alternatively, the laser is used cosmetically; it can remove wrinkles, birthmarks, or tattoos.

The special light beam is focused to treat tissues by heating the cells until they burst. There are a number of different laser types. Each has a different use and color. The color, or the light beam, relates to the type of surgery that is being performed and the color of the tissue that is being treated. There are three types of laser: the carbon dioxide (CO₂) laser; the YAG laser (yttrium aluminum garnet); and the pulsed dye laser.

Purpose

Laser surgery is used to:

• cut or destroy tissue that is abnormal or diseased without harming healthy, normal tissue
• shrink or destroy tumors and lesions
• close off nerve endings to reduce postoperative pain
• cauterize (seal) blood vessels to reduce blood loss
• seal lymph vessels to minimize swelling and decrease spread of tumor cells
• remove moles, warts, and tattoos
• decrease the appearance of skin wrinkles

Precautions

Anyone who is thinking about having laser surgery should ask the surgeon to:

• explain why laser surgery is likely to be of greater benefit than traditional surgery
• describe the surgeon's experience in performing the laser procedure the patient is considering

Because some lasers can temporarily or permanently discolor the skin of blacks, Asians, and Hispanics, a dark-skinned patient should make sure that the surgeon has successfully performed laser procedures on people of color. Potential problems include infection, pain, scarring, and changes in skin color.

Some types of laser surgery should not be performed on pregnant women or on patients with severe cardiopulmonary disease or other serious health problems.

Additionally, because some laser surgical procedures are performed under general anesthesia, its risks should be fully discussed with the anesthesiologist. The patient should fully disclose all over-the-counter and prescription medications that are being taken, as well as the foods and beverages that are generally consumed; some can interact with agents used in anesthesia.

Description

Lasers can be used to perform almost any surgical procedure. In fact, general surgeons employ the various laser wavelengths and laser delivery systems to cut, coagulate, vaporize, and remove tissue. In most "laser surgeries," they actually use genuine laser devices in place of conventional surgical tools—scalpels, cryosugery probes, electrosurgical units, or microwave devices—to carry out standard procedures, like mastectomy (breast surgery). With the use of lasers, the skilled and trained surgeon can accomplish tasks that are more complex, all the while reducing blood loss, decreasing postoperative patient discomfort, decreasing the chances of infection to the wound, reducing the spread of some cancers, minimizing the extent of surgery (in some cases), and achieving better outcomes in wound healing. Also, because lasers are more precise, the laser can penetrate tissue by adjusting the intensity of the light.

Lasers are also extremely useful in both open and laparoscopic procedures. Common surgical uses include breast surgery, removal of the gallbladder, hernia repair, bowel resection, hemorrhoidectomy, solid organ surgery, and treatment of pilonidal cyst.

The first working laser was introduced in 1960. Initially used to treat diseases and disorders of the eye, the device was first used to treat diseases and disorders of the eye, whose transparent tissues gave ophthalmic surgeons a clear view of how the narrow, concentrated beam was being directed. Dermatologic surgeons also helped to pioneer laser surgery, and developed and improved upon many early techniques and more refined surgical procedures.

Types of lasers

The three types of lasers most often used in medical treatment are the:

• Carbon dioxide (CO₂) laser. Primarily a surgical tool, this device converts light energy to heat strong enough to minimize bleeding, while cutting through or vaporizes tissue.
• Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. Capable of penetrating tissue more deeply than other lasers, the Nd:YAG laser enables blood to clot quickly, allowing surgeons to see and can enable surgeons to see and touch body parts that could otherwise be reached only through open (invasive) surgery.
• Argon laser. This laser provides the limited penetration needed for eye surgery and superficial skin disorders. In a special procedure known as photodynamic therapy (PDT), this laser uses light-sensitive dyes to shrink or dissolve tumors.