Transurethral laser urethrotomy in man: preliminary report.

After in vitro and in vivo endoscopic laser investigation on normal and experimentally strictured urethras in dogs transurethral laser urethrotomy was done on men. A neodymium: yttrium aluminum garnet laser with a flexible laser light guide was used. The endoscope developed for this purpose is described in detail. The first laser operations were without complications.     

Requirements of an up to date fibre optics delivery system for laser medicine

The possibility of the potential as well as the safety of an optical fibre delivery system for laser medical applications is reviewed. Fibre directional couplers and connectors are suggested to be developed in view of this power laser application. Finally a special fibre probe radiating a corolla shaped beam for laser angioplasty is briefly described.     

Laser therapy for the treatment of brain tumors.

The author examine the specific cases where laser therapy may be indicated for the treatment of brain tumors. The different types of lasers currently available are described and the effects on the tissue, at different powers and with different modalities of use, are reported. On the basis of experience reported in literature, the Author describes the characteristics and the fields of application of the 1.32 nm Nd:YAG laser, the superpulse CO2 and the Nd:YAG with sapphire tips for contact laser surgery. The advantages of laser surgery as opposed to the traditional techniques in the most frequently observed tumors, are also described.     

Basic principles of lasers

The theoretical basis for laser was first described by Einstein, over 100 years ago. Lasers are now in widespread use and have an extensive range of applications, including many within the field of medicine. This article explores the properties of laser its physical principles and the main components required to produce a laser beam. The specific properties of laser, render it an extremely useful clinical tool in a variety of circumstances. The application of laser also brings potential hazards, which are discussed, along with the safety measures utilized to minimize the associated risk.     

GENERAL ANAESTHESIA FOR CARBON DIOXIDE LASER SURGERY WITHIN THE AIRWAY: A Review

Carbon dioxide laser surgery in the airway presents the anaesthetistwith new problems. The mode of action of carbon dioxide lasersand its effects on anaesthetic agents and equipment are described.Complications, especially of fire hazards in the airway, andmethods of avoiding them are set out in detail. Various anaesthetictechniques for both laryngeal and tracheobronchial laser surgeryare described.     

Lasers in medicine

Since its discovery, the laser has been intensively investigated and used in medicine, first in ophthalmology then in ear, nose and throat surgery, gynaecology, neurosurgery etc. Development spans from the ruby and argon lasers in outpatient eye surgery to the carbon dioxide and Nd:YAG lasers in the operating theatres and further on to the PDT-dye lasers, excimer and solid state angioplasty lasers or flash lamp pumped "gallstone cracker" lasers. The CO2-Nd: YAG laser combination will be described as the state-of-art surgical laser. This simultaneous, coaxial and coherent combination laser offers a new possibility to cut and coagulate effectively at the same time. Operating times are shortened and bleeding volumes minimised. The CO2-Nd: YAG laser represents a new type of interaction between laser and tissue, laser enhanced tissue absorption, which will be described.     

Minocycline-Induced Hyperpigmentation Treated with a 755-nm Q-Switched Alexandrite Laser

BACKGROUND: Cutaneous pigmentation associated with minocycline therapy is an unusual adverse effect for which few successful treatments have been described. The pigment changes may persist for years, despite cessation of therapy, and is often cosmetically disfiguring, causing significant embarrassment and psychological depression in those affected. Few safe and effective treatments have been described in the past; however, recent pigment-specific laser technology has shown promise in the treatment of this condition. OBJECTIVE: The objective was to describe a series of patients with minocycline-induced hyperpigmentation who were successfully treated with a 755-nm Q-switched alexandrite laser. METHODS: Six patients with minocycline-induced hyperpigmentation on the face or legs were treated with a Q-switched alexandrite laser on a bimonthly basis until pigmentation was eradicated. RESULTS: Cutaneous pigmentation resolved completely in all patients in an average of four laser sessions. Side effects were limited to transient purpura and mild desquamation without scarring or dyspigmentation. CONCLUSION: Minocycline-induced cutaneous pigmentation can be effectively cleared without risk of adverse sequelae by Q-switched alexandrite (755-nm) laser irradiation.     

Hysteroscope for CO2 laser application

Endoscopic laser surgery is becoming more common with the development of suitable instruments. A hysteroscope designed for use with a Sharplan CO₂ laser is described in detail. The method of application, results of preliminary experience, and possible indications are discussed.     

Holmium:YAG laser endoureterotomy in the treatment of ureteroenteric stricture following Indiana urinary diversion

A 57-year-old man who had received radical urethrocystectomy and Indiana urinary diversion 6 months earlier was treated for ureteroenteric anastomosis stricture (left side) using a Holmium:YAG laser via antegrade approach. The availability of small (6.9 Fr) flexible ureteroscope, as well as the use of the Holmium:YAG laser has facilitated the ability to precisely incise the stricture under direct endoscopic visualization. The technique is described for laser endoureterotomy in a patient with ureteroenteric stricture following Indiana urinary diversion.     

Slit lamp laser doppler interferometer

A slit lamp laser interferometer is described for clinical in vivo eye length measurements. The basic components are a laser Doppler interferometer, a slit lamp attachment, and a commercial slit lamp. First measurements of the axial length of the eye yielded a standard deviation of 0.04 mm and less. © 1993 Wiley-Liss, Inc.     

Systemic air embolism as a possible cause of cardiac arrest during endoscopic treatment of pulmonary haemangioma using a diode laser

Air embolism is a known but rare complication to endoscopic laser surgery. A case of nearly lethal air emboli as a complication to endoscopic laser surgery using a diode laser in the lungs is described. The case illustrates that even after prolonged resuscitation a successful outcome can be obtained.     

Surgical laser application in thoracic surgery. Potential and critical evaluation

A 25-year experience of pulmonary and pleural surgery in 348 patients, reconstructive esophageal operations in 74 patients, bronchoscopic interventions using different laser techniques--in 925 patients, and thoracoscopic operations of traumatic and spontaneous pneumothorax--in 150 patients has been summarized. The methods of laser pulmonary resection, processing of bronchial stump, fibrous capsule, pleurodesis, stitching of esophagogastric, esophagointestinal and interintestinal anastomoses and of bronchoscopic photo destruction of tracheal and bronchial tumors have been described. Haemostatic, bactericidal and ablastic properties of laser have been described. Lasers were used in miniinvasive thoracic surgery for thoracoscopic and videothoracoscopic interventions.     

Carbon dioxide laser surgery for cervical intra-epithelial neoplasia. A report on 300 cases

The CO2 laser was used to treat 300 patients with cervical intra-epithelial neoplasia (CIN). The patient characteristics, histological features, complications and follow-up are described and our experience is discussed. The CO2 laser appears to be safe and efficient for outpatient treatment of CIN, with a cure rate of 94%.     

Endoscopic surgery of pneumothorax

Thoracoscopy was conducted in 223 patients with spontaneous and traumatic pneumothorax; 26 of them were treated by diathermal coagulation of the lungs, thoracic wall, and bleeding vessels, 34--by laser photocoagulation. Nd-laser with a wave length of 1.06 mcm was used as the source of laser radiation. The indications for thoracoscopy and the techniques of using laser radiation in thoracoscopy are described. Diathermal coagulation of the lung failed to produce an effect in 2 patients with spontaneous pneumothorax, laser photocoagulation was ineffective in 3 patients with spontaneous pneumothorax and in one patient with a knife injury of the right lung. Laser photocoagulation has advantages over diathermal coagulation.     

Contact laser: thermal sclerostomy ab interna

An experimental technique utilizing a sapphire contact laser probe for thermal sclerostomy ab interna is described. The contact laser probe with a tip diameter of 0.2 mm is brought in contact with the trabecular meshwork. Using 3.50 watts of cw Nd:YAG at 0.1 second duration, three to five exposures established communication between anterior chamber and subconjunctival space in pigmented rabbits.     

Carbon dioxide laser vaporization of facial siliconomas: flash in the pan or way of the future?

In 1988, Becker first described the "laser silicone flash" encountered while using the CO2 laser to remove breast siliconosis, but no subsequent use of the CO2 laser to remove siliconomas has been reported since. To our knowledge, lasers have not been described to treat facial silicone granulomas.Three cases of facial silicone granuloma (cheek, upper eyelids, and chin) were treated using the technique of CO2 laser vaporization.We describe a novel and effective method to remove facial siliconomas. This technique could avoid the need for radical resection of functional facial tissues such as nerves. Tiny globules of injected silicone in the face were vaporized without any untoward effects. Whether larger siliconomas can be treated in the same way remains to be seen and is an area of potential study.     

Microprocessor-controlled scanning micromanipulator for carbon dioxide laser surgery. Technical note

A microprocessor-controlled scanning device for use in carbon dioxide laser surgery is described. This device increases the speed of dissection, allows the surgeon to keep both hands in the operative field, and thereby decreases the fatigue associated with manual control of the micromanipulator used in a surgical laser system.     

Interstitial laser thermotherapy in neurosurgery: A review

Summary One of the most recent laser treatment modalities in neurosurgery is interstitial laser thermotherapy (ILTT). In this review, experimental and clinical studies concerning intracranial ILTT are discussed. Two methods for intra-operative control of the laser induced lesions are described; i.e., computer-controlled power delivery, using a thermocouple that is positioned interstitially at the periphery of the tumour to maintain the desired temperature at that point, and MRI, to visualise the extent of the thermal lesions induced by ILTT. The results show that ILTT using a Nd:YAG laser is easy and relatively effective in the treatment of small deepseated brain tumours with minimal risk and complications. This review is concluded with suggestions for further improvement of this treatment modality.     

Management of rhinophyma with carbon dioxide laser: Lahey Clinic experience

The carbon dioxide (CO2) laser as a surgical tool for the difficult cosmetic problem of rhinophyma permits unprecedented refinement in treatment. Previously described conventional techniques have included the cold knife and the dermabrader. With these methods, hemostasis must be obtained with electrocautery, which if used extensively makes fine sculpting difficult. Seven patients with rhinophyma were treated with the CO2 laser at the Lahey Clinic from 1982 to 1987. We used a laser handpiece with a variable spot size. With this technique, we found the laser to be an excellent cutting tool while simultaneously providing superior hemostasis. In the followup period of up to 4.5 years, the cosmetic results have been excellent. Thus, the CO2 laser has become our treatment of choice for the management of patients with rhinophyma.