Soft tissue laser surgery
Encyclopedia
In soft tissue
laser surgery
, interaction of laser light with the soft tissue provides a special approach to surgery. A highly focused laser beam vaporizes the soft tissue
with the high water content. Laser can make very small incisions when the beam is focused on the tissue (focal spot size can be as small as =0.1 mm, but the most widely used in practice is 0.4 mm). When the beam is defocused, the intensity of the laser light on the tissue diminishes, and it can be used for cauterization of small blood vessels and lymphatics, therefore decreases post-operative swellings.
A laser beam has a natural sterilization effect—it evaporates bacteria, viruses and fungi, which leads to a decrease in local infections. Probably most important, the laser decreases post-operative pain by sealing nerve endings. Soft Tissue Laser Surgery is differentiated from Hard Tissue Laser Surgery (bone
s and teeth in dentistry
) and Laser Eye Surgery (eyesight corrective surgeries ) by the type of lasers used in a particular type of laser surgery.
Hard Tissue surgical lasers are dominated by Er:YAG laser
s operating at the wavelengths around 3,000 nm. Laser Eye Surgeries utilize excimer
lasers in the UV range of wavelengths. Unlike many solid-state and diode lasers in the visible and near infrared wavelength range (600-2,000 nm), the Carbon dioxide or CO2 laser
wavelength (10,600 nm) is highly absorbed by in-vivo soft tissues containing water. Furthermore, modern CO2 laser technology makes these lasers far more affordable than solid-state Er:YAG lasers, which also feature a wavelength that is highly absorbed by water. Because of their wavelength and precision, CO2 lasers remain the dominant soft tissue surgical lasers.
Surgical laser systems are differentiated not only by the wavelength, but also by the light delivery system: flexible fiber or articulated arm, as well as by other factors.
Soft tissue laser surgery is used in a variety of applications in human (General surgery
, Neurosurgery
, ENT
, Dentistry
, Oral and Maxillofacial Surgery
etc.) as well as veterinary surgical fields.
Soft tissue
In anatomy, the term soft tissue refers to tissues that connect, support, or surround other structures and organs of the body, not being bone. Soft tissue includes tendons, ligaments, fascia, skin, fibrous tissues, fat, and synovial membranes , and muscles, nerves and blood vessels .It is sometimes...
laser surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
, interaction of laser light with the soft tissue provides a special approach to surgery. A highly focused laser beam vaporizes the soft tissue
Biological tissue
Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...
with the high water content. Laser can make very small incisions when the beam is focused on the tissue (focal spot size can be as small as =0.1 mm, but the most widely used in practice is 0.4 mm). When the beam is defocused, the intensity of the laser light on the tissue diminishes, and it can be used for cauterization of small blood vessels and lymphatics, therefore decreases post-operative swellings.
A laser beam has a natural sterilization effect—it evaporates bacteria, viruses and fungi, which leads to a decrease in local infections. Probably most important, the laser decreases post-operative pain by sealing nerve endings. Soft Tissue Laser Surgery is differentiated from Hard Tissue Laser Surgery (bone
Bone
Bones are rigid organs that constitute part of the endoskeleton of vertebrates. They support, and protect the various organs of the body, produce red and white blood cells and store minerals. Bone tissue is a type of dense connective tissue...
s and teeth in dentistry
Dentistry
Dentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered...
) and Laser Eye Surgery (eyesight corrective surgeries ) by the type of lasers used in a particular type of laser surgery.
Hard Tissue surgical lasers are dominated by Er:YAG laser
Er:YAG laser
Er:YAG lasers are solid-state lasers whose lasing medium is erbium-doped yttrium aluminium garnet . Er:YAG lasers typically emit light with a wavelength of 2940 nm, which is infrared light. Unlike Nd:YAG lasers, the output of an Er:YAG laser is strongly absorbed by water because of atomic resonances...
s operating at the wavelengths around 3,000 nm. Laser Eye Surgeries utilize excimer
Excimer
An excimer is a short-lived dimeric or heterodimeric molecule formed from two species, at least one of which is in an electronic excited state. Excimers are often diatomic and are composed of two atoms or molecules that would not bond if both were in the ground state. The lifetime of an excimer is...
lasers in the UV range of wavelengths. Unlike many solid-state and diode lasers in the visible and near infrared wavelength range (600-2,000 nm), the Carbon dioxide or CO2 laser
Carbon dioxide laser
The carbon dioxide laser was one of the earliest gas lasers to be developed , and is still one of the most useful. Carbon dioxide lasers are the highest-power continuous wave lasers that are currently available...
wavelength (10,600 nm) is highly absorbed by in-vivo soft tissues containing water. Furthermore, modern CO2 laser technology makes these lasers far more affordable than solid-state Er:YAG lasers, which also feature a wavelength that is highly absorbed by water. Because of their wavelength and precision, CO2 lasers remain the dominant soft tissue surgical lasers.
Surgical laser systems are differentiated not only by the wavelength, but also by the light delivery system: flexible fiber or articulated arm, as well as by other factors.
Soft tissue laser surgery is used in a variety of applications in human (General surgery
General surgery
General surgery, despite its name, is a surgical specialty that focuses on abdominal organs, e.g., intestines including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bile ducts, and often the thyroid gland . They also deal with diseases involving the skin, breast, soft...
, Neurosurgery
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...
, ENT
Otolaryngology
Otolaryngology or ENT is the branch of medicine and surgery that specializes in the diagnosis and treatment of ear, nose, throat, and head and neck disorders....
, Dentistry
Dentistry
Dentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered...
, Oral and Maxillofacial Surgery
Oral and maxillofacial surgery
Oral and maxillofacial surgery is surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. It is an internationally recognized surgical specialty...
etc.) as well as veterinary surgical fields.