Last updated: 11/24/2009

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.

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.