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Insight into LASER surgery

What is a laser?
LASER stands for Light Amplification by Stimulated Emission of Radiation. A laser is an opto-electronic device that produces highly concentrated light rays. Laser power may range from milliWatts (in CD-ROM drives and laser pointers) to dozens of Watts (industrial and medical applications) and over trillions of Watts (pulsed lasers in scientific and military applications).

What is laser surgery?
Interaction of laser light with tissue provides a fundamentally different approach to surgery. In laser surgery, a highly focused laser beam can efficiently ablate (either vaporize or chip away) the living tissue. At the same time, it seals (welds) capillaries, small blood vessels, lymphatics, and nerve endings, with significant benefits to both patients and surgeons.

What is the most efficient soft-tissue surgical laser?
Soft Tissue Laser Surgery is different from Hard Tissue Laser Surgery (bones and teeth in dentistry) and Laser Eye Surgery (eye sight corrective surgeries) by particular types of lasers. Lasers differ from each other by the wavelength of light they produce. The most commonly used surgical laser in soft tissue surgery is the CO2 laser. The CO2 laser wavelength (10.6 micrometers) is highly absorbed by water contained in soft tissue. Because of its outstanding versatility and precision, the CO2 surgical laser is the most efficient and dominant soft tissue surgical laser since the 1960s. Laser surgery is widely practiced in many applications of human as well as veterinary medicine.

Why Laser sugery

Benefits for patient:
  • Less Bleeding: As it cuts, the laser seals small blood vessels. This drastic reduction in bleeding enables a number of new surgical procedures that are not practical with conventional scalpel.

  • Less Pain: The CO2 laser beam seals nerve endings and lymphatics, resulting in less edema and pain. The patient experiences a far more comfortable post-operative recovery.

  • Reduced risk of infection: This is one of the unique features of the CO2 laser beam. It efficiently kills bacteria in its path, producing a sterilizing effect.

  • Quicker recovery time: Reduced risk of infection, less bleeding, less pain and less swelling often allow the patient a far quicker recovery after the surgery.

Benefits for surgeons:
  • Unique surgical capabilities: Laser surgery improves many surgical procedures by making them simpler and reducing risk. This enables surgeries that are not practical with conventional methods.

  • Enhanced visibility of the surgical field: The laser light seals capillaries and small blood vessels as it cuts, thereby dramatically reducing bleeding. This results in a much clearer and drier surgical site.

  • Increased precision and control: The focal spot size of the beam may be adjusted down to a small fraction of a millimeter or expanded for a much wider coverage. The laser power may be set for rapid removal of relatively large tissue amounts, or adjusted to remove only one cell layer at a time.

  • Reduction of surgery time: The hemostatic effect of the laser beam and the improved visibility of the surgical field often reduce the duration of the surgery.
Veterinary Laser Surgery

General surgery procedures:Traumatic wound debridement, Perianal tumors, Toe Nail Lasing, Amputations, Tumor bed ablations, Cranial cruciate ligament rupture debridement, Graft bed preparation-infected wounds,Transitional cell carcinoma of bladder, Perianal fistulas, Tumor/mass removal, Urethral prolapse resections, Urinary bladder polyps, Vaginal tumor excisions - leiomyoma, SCC and fibrosarcoma, Anal saculectomy.

Further reading: "Soft Tissue Application of Lasers",Vet Clin Small Anim 32 (2002) 569-599, Elsevier Science (USA)

  1. Opthamology surgery procedures:
    Conjunctiva treatment, Cherry Eye, Distichia, Ectopic cilia, Lacrimal Punctotomy for Epiphora, Entropion, Meibomium Gland Excision, Eyelid tumor removal, Hemangioma removal, Scleral corneal mass removal, Keratectomy, Mast cell tumors, Squamous cell carcinoma removal, Epiphora.

    Further reading: Vet Clin Small Anim 32 (2002) 649-672. Elsevier Science, (USA)

  2. ENT and oral surgery procedures:
    Oral mass excision, Gingivectomy/plasty Incisional Biopsy, Aural Hemotoma, Bulla curettage, Ear canal ablation, Correction of faulty ear carriage, Epulis removal, Gingival hyperplasia, Sublingual tissue, Laryngeal granuloma, Ventriculochordectomy, Laryngeal scar removal, Ear crop, Lymphocytic plasmacytic stomatitis, Nasal Hyperkeratosis, Nasal Planum Resection, Osteosarcoma of palate, Ear canal polyps, Partial mandibulctomies, Periodontal flap surgery, Partial maxillectomies, Proliferative otitis - sterilization and ablation, Laryngeal web revision, Ramulas, Salivary gland removal, Salivary mucoceles, Soft palate resection, Squamous cell carcinoma, Stenotic nares, Folds, Sublingual Sialocele, Acanthomastous Epulis, Tongue lesions, Tonsillectomy, Everted laryngeal saccules, Throughing for crown impressions.

    Further reading: Laser Use in Veterinary Dentistry, Vet Clin Small Anim 32 (2002) 673-692. Elsevier Science, (USA)

  3. Dermatology surgery procedures:
    Acral lick granuloma ablation, Cutaneous masses: skin tags, Follicular cysts and tumors, Gingival hyperplasia and epulis, Hyperkeratosis of digital pads /nasal planum, Hemostasis, Malignant melanoma, Localized demodex,inclusion cysts, papillomas, Epibulbar melanoma, Pigmented viral plaques, Actinic keratosis, Pinnal tumors, Feline ceruminous cystomatosis, Calcinosis circumscripta, Squamous cell carcinoma removal, Viral papillomas, Wound management (acute and chronic), Nodular sebaceous hyperplasia, Plasma cell pododermatitis.

    Further reading: Lasers in Veterinary Dermatology, Vet Clin Small Anim 36 (2006) 15-37,Elsevier Science (USA)

What is Laparoscopy?

Laparoscopy is a minimally invasive surgery that uses a light source and a camera to visualize organs and perform surgical procedures in the abdominal cavity. It is used in both human and veterinary medicine.

What Kinds of Procedures Can be done with a Laparoscope?
  • Exploratory Surgery: The most common procedures include exploratory surgery. Exploratory surgery is used to evaluate the internal organs and look for masses, diseased organs or other abnormalities.

  • Organ or Mass Biopsy: A biopsy is a procedure used to obtain pieces of tissue to evaluate for disease. Laparoscopy can be used to aid in the biopsy of almost any

  • Other abdominal procedures include: examination of draining tracks and deep wounds, bladder surgery, gastropexy (tacking of the stomach in "bloat prone breeds"), gall bladder removal, and intestinal foreign body removal.

  • The equipment can also be used to explore the chest cavity and perform various chest surgeries.

Using a Laparoscope means a surgery that is minimally invasive. This presents many benefits to patient and client.

What are the advantages of Laparoscopy?
  • Laparoscopy is not as traumatic as traditional open-abdomen surgeries

  • There is faster surgical recovery compared to traditional open abdomen surgeries

  • Because recovery is faster, there is less hospital time and lower cost to the owner

  • It is less painful compared to traditional open-abdomen surgeries

  • Biopsies of organs and masses can be visualized and monitored for bleeding and other complications

What are the disadvantages of Laparoscopy?

Although visualization with the laparoscope is very good, small masses or abnormalities may be missed if they are in a difficult area to visualize with the camera.

In general, the advantages of laparoscopy far outweigh the disadvantages.
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