Laser Surgery Health Article

Laser applications

Sometimes described as "scalpels of light," lasers are used alone or with conventional surgical instruments in a array of procedures that:

• improve appearance
• relieve pain
• restore function
• save lives

Laser surgery is often standard operating procedure for specialists in:

• cardiology (branch of medicine which deals with the heart and its diseases)
• dentistry (branch of medicine which deals with the anatomy and development and diseases of the teeth)
• dermatology (science which treats the skin, its structure, functions, and its diseases)
• gastroenterology (science which treats disorders of the stomach and intestines)
• gynecology (science which treats of the structure and diseases of women)
• neurosurgery (surgery of the nervous system)
• oncology (cancer treatment)
• ophthalmology (treatment of disorders of the eye)
• orthopedics (treatment of disorders of bones, joints, muscles, ligaments, and tendons)
• otolaryngology (treatment of disorders of the ears, nose, and throat)
• pulmonology (treatment of disorders of the respiratory system)
• urology (treatment of disorders of the urinary tract and of the male reproductive system)

Routine uses of lasers, include eliminating birth-marks, skin discoloration, and skin changes due to aging, and removing benign, precancerous, or cancerous tissues or tumors. Lasers are used to stop a patient's snoring, remove tonsils, remove or transplant hair, and relieve pain and restore function in patients who are too weak to undergo major surgery. Lasers are also used to treat:

• angina (chest pain)
• cancerous or noncancerous tumors that cannot be removed or destroyed
• cold and canker sores, gum disease, and tooth sensitivity or decay
• ectopic pregnancy (development of a fertilized egg outside the uterus)
• endometriosis
• fibroid tumors
• gallstones
• glaucoma, mild-to-moderate nearsightedness and astigmatism, and other conditions that impair sight
• migraine headaches
• noncancerous enlargement of the prostate gland
• nosebleeds
• ovarian cysts
• ulcers
• varicose veins
• warts
• numerous other conditions, diseases, and disorders

Advantages of laser surgery

Often referred to as "bloodless surgery," laser procedures usually involve less bleeding than conventional surgery. The heat generated by the laser keeps the surgical site free of germs and reduces the risk of infection. Because a smaller incision is required, laser procedures often take less time (and cost less money) than traditional surgery. Sealing off blood vessels and nerves reduces bleeding, swelling, scarring, pain, and the length of the recovery period.

Disadvantages of laser surgery

Although many laser surgeries can be performed in a doctor's office, rather than in a hospital, the person guiding the laser must be at least as thoroughly trained and highly skilled as someone performing the same procedure in a hospital setting. The American Society for Laser Medicine and Surgery urges that:

• All operative areas be equipped with oxygen and other drugs and equipment required for cardiopulmonary resuscitation (CPR).
• Non-physicians 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 acute care facility (ACF) be available whenever laser surgery is performed in a non-hospital setting.

Diagnosis/Preparation

Because laser surgery is used to treat so many diverse conditions, the patient should ask the physician for detailed instructions about how to prepare for a specific procedure. Diet, activities, and medications may not have to be limited prior to surgery, but some procedures require a physical examination, a medical history, and conversation with the patient that:

• enables the doctor to evaluate the patient's general health and current medical status
• provides the doctor with information about how the patient has responded to other illnesses, hospital stays, and diagnostic or therapeutic procedures
• clarifies what the patient expects the outcome of the procedure to be

Aftercare

Most laser surgeries can be performed on an outpatient basis, and patients are usually permitted to leave the hospital or medical office when their vital signs have stabilized. A patient who has been sedated should not be discharged until recovery from the anesthesia is complete, unless a responsible adult is available to accompany the patient home.

The doctor may prescribe analgesic (pain-relieving) medication, and should provide easy-to-understand, written instructions on how to take the medication. The doctor should also be able to give the patient a good estimate of how the patient's recovery should progress, the recovery time, and what to do in case complications or emergency arise. The amount of time it takes for the patient to recover from surgery depends on the surgery and on the individual. Recovery time for laser surgery is, for the most part, faster than for traditional surgery.