Laser surgery

Not to be confused with [[:Laser hair removal]].

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Laser surgery is a type of surgery that uses a laser instead of a traditional scalpel to cut or remove tissue. It is widely used in various medical specialties due to its precision, minimal invasiveness, and reduced healing time.

Laser surgery is commonly employed in ophthalmology, dermatology, dentistry, oncology, and vascular surgery. Different types of surgical lasers, such as CO₂ laser, Nd:YAG laser, argon laser, and excimer laser, are used based on the wavelength and intended medical application.

Types of Laser Surgery

Laser surgery is categorized based on tissue interaction and medical application.

Soft-Tissue Laser Surgery

Soft-tissue laser surgery is used to cut, coagulate, vaporize, and ablate soft tissues with high water content. Common applications include:

• Otolaryngology (ENT surgery) – Treatment of polyps, tumors, and lesions in the larynx and nasal cavity.
• Dentistry and Oral Surgery – Gingivectomy, frenectomy, crown lengthening, and treatment of periodontal disease.
• Dermatology – Used for scar removal, skin resurfacing, vascular lesions, and tattoo removal.
• Gynecology – Removal of uterine fibroids, endometriosis, and cervical dysplasia.
• Veterinary Surgery – Utilized for tumor removal and wound healing in animals.

Effects of Laser on Soft Tissue Lasers interact with soft tissue through different mechanisms:

1. Photochemical effect – Used in photodynamic therapy (PDT) to destroy cancerous or abnormal tissue.
2. Photoablative effect – Used in refractive eye surgery, such as LASIK and photorefractive keratectomy (PRK).
3. Photothermal effect – Used in endoscopic hemostasis, such as stopping bleeding from peptic ulcer disease or esophageal varices.
4. Photomechanical effect – Used in lithotripsy to break down kidney or gallstones.

Hard-Tissue Laser Surgery

Hard-tissue lasers are used for cutting and reshaping bones and teeth, primarily in dentistry and orthopedics.

• Dentistry – Used for cavity preparation, root canal sterilization, and enamel etching.
• Orthopedic surgery – Used in bone sculpting, fracture healing, and spinal decompression.

Common Types of Surgical Lasers

Various types of lasers are used depending on wavelength and medical application:

• Carbon dioxide laser (CO₂ laser) – Used for skin resurfacing, tumor removal, and ENT surgery.
• Nd:YAG laser – Used in oncology, vascular surgery, and ophthalmology.
• Argon laser – Used in ophthalmology and dermatology.
• Excimer laser – Used in refractive eye surgery like LASIK.
• Diode laser – Used in dentistry and dermatology.

Applications of Laser Surgery

Ophthalmology

LASIK surgery using an excimer laser.

Laser surgery is extensively used in ophthalmology for treating refractive errors and retinal conditions:

• LASIK (Laser-Assisted In Situ Keratomileusis) – Reshapes the cornea to correct myopia, hyperopia, and astigmatism.
• Photorefractive keratectomy (PRK) – Similar to LASIK but without creating a corneal flap.
• Phototherapeutic keratectomy (PTK) – Removes corneal opacities and irregularities.
• Laser coagulation – Used for treating diabetic retinopathy and retinal tears.

Dermatology and Plastic Surgery Laser surgery is widely used in dermatology for aesthetic and medical treatments:

• Laser resurfacing – Removes wrinkles, scars, and sun damage.
• Treatment of vascular lesions – Used for spider veins and port-wine stains.
• Tattoo removal – Uses Q-switched lasers to break down ink particles.

Oncology Laser surgery is employed in cancer treatment, particularly for:

• Tumor ablation – Destroying cancerous tissues in the lungs, liver, and esophagus.
• Palliative care – Reducing tumor mass to alleviate symptoms in advanced cancer patients.

Vascular and Endovascular Surgery Laser techniques are used for vascular conditions:

• Endovenous laser treatment (EVLT) – Treats varicose veins.
• Laser-assisted angioplasty – Helps open blocked arteries.
• Laser endarterectomy – Used to remove atherosclerotic plaque from arteries.

Gastrointestinal Surgery Laser surgery is applied in the treatment of:

• Gastrointestinal bleeding – Laser coagulation stops bleeding from peptic ulcers and esophageal varices.
• Laser-assisted hemorrhoidectomy – A minimally invasive alternative for hemorrhoid removal.
• Tumor ablation – Used for early-stage esophageal and colorectal cancers.

Dental Surgery Lasers are used in soft and hard tissue dental procedures:

• Gingivectomy – Removal of excess gum tissue.
• Frenectomy – Correction of tongue-tie or lip-tie conditions.
• Cavity preparation – Laser drills can remove decayed enamel with minimal pain.

Neurosurgery Laser surgery is used in brain and spinal procedures:

• Tumor removal – Laser therapy can precisely target brain tumors.
• Laser spine surgery – Minimally invasive approach for herniated discs.

Advantages of Laser Surgery

Laser surgery offers several advantages over traditional surgical methods:

• Minimally invasive – Reduces tissue damage and scarring.
• Precision – Targets specific tissues with minimal impact on surrounding areas.
• Reduced blood loss – Lasers cauterize blood vessels, minimizing bleeding.
• Faster recovery – Less post-operative pain and quicker healing.
• Reduced infection risk – Laser sterilization reduces the chance of bacterial infection.

Disadvantages and Risks

Despite its benefits, laser surgery has potential risks:

• Thermal damage – Excessive laser energy can burn adjacent tissues.
• Expensive equipment – Requires high-cost lasers and specialized training.
• Limited applications – Some procedures still require traditional surgery.
• Potential side effects – May cause scarring, pigmentation changes, or nerve damage.

See Also

• Laser medicine
• Photodynamic therapy
• Minimally invasive surgery
• Laser-assisted liposuction
• Endovenous laser treatment

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