1. L aser s Used i n the M edi cal F i eld
• E l la hae been used in avrietyof wy
dica sers v a as
for m nyy rs. M l la a used for cosm
a ea edica sers re etic
procedures, surg a dianostic procedures. T
ery nd g he
vria of frequency pow a wv
a tions , er nd ae
m surem sepa te both the ty of la tha
ea ents ra pes sers t
hae been dev
v eloped a the mria wy in w
nd y d as hich
the different la m ybe used. N ty of
sers a ew pes
trea ent hae been dev
tm v eloped in conjunction with
newty of m l la
pes edica sers.
2. In the ea das of la it ca e a asurprise tha these tools of lig -
rly y sers m s t ht
could be used in the science of m edicine, since no one env isioned tha they
t
m ht be a to hea or otherw im e people's phy l w being
ig ble l ise prov sica ell- .
B doctors a m l resea
ut nd edica rchers quicklybeg n to see the possibilities,
a
a the num of uses for m l la m
nd ber edica sers ultiplied ov the y rs.
er ea
Aong other a tions, these include cutting into tissue in surg l
m pplica ica
procedures; resha the corneaof the ey to im e sig clea
ping e prov ht; ning
clog ed a
g rteries; burning a a caities a w
wy v nd hitening the teeth; rem ing ov
unwnted ha w
a ir, rinkles, birthm rks, a freckles; a resha the fa
a nd nd ping ce
.in pla surg procedures
stic ery
3. "T he A dvent of the " L aser Scal pel
Erlyexperim
a enters w m l la pointed out tha there a surg l-
ith edica sers t re ica
opera tha a difficult to perform w the conv l sca a
tions t re ith entiona lpel nd
tha ala bea m ht be used instea Initia tria show tha afinely
t ser m ig d. l ls ed t
focused bea from aca dioxide g s la could cut throug hum n
m rbon a ser h a
tissue ea a nea . T surg could direct the bea from a a le
sily nd tly he eon m ny ng
.byusing am m irror ounted on am a m l a
ovble eta rm
4. • S era a a ges of la surgeryquicklybeca e a rent. F the light bea is
ev l dvnta ser m ppa irst, m
consistent, w m ns tha it g es off the sa e a ount of energ from n this photo
hich ea t iv m m y I
taken during open-heartsurgery, a doctor uses a laser probeto punch small
holes in thepatient's heartmuscleto increase theorgan's blood flow .
• one second to the next. S a long a the bea is mov a , the cut it ma (the
os s m ing long kes
incision) does not vryin depth; w s w using asca adoctor ca a
a herea hen lpel n ccidentally
m ke pa of the incision too deep. A
a rt second a a g of the surg l la is tha the hot
dvntae ica ser t
bea ca
m uterizes, or sea off, the open blood v a it m es a . ( his w w
ls essels s ov long T orks ell
m inlyfor sm ll v such a those in the skin. T doctor still ha to sea off the
a a essels, s he s l
la er blood v using conv l m
rg essels entiona ethods.) S a
till nother a a g is tha the cells
dvntae t
in hum n tissue do not conduct hea v w so the skin or a other tissue nea the
a t ery ell, ny r
la incision does not g v hot a is not a
ser et ery nd ffected bythe bea . T a a g of la
m his dvntae ser
surg is v helpful w adoctor m opera on atinya tha is surrounded by
ery ery hen ust te rea t
hea tissue or org ns. It should be pointed out tha the "la sca is not
lthy a t ser lpel"
necessa the best tool to use in ev opera S e doctors feel tha w the la
rily ery tion. om t hile ser
is useful in som situa it w nev tota repla the sca O a m
e tions, ill er lly ce lpel. thers re ore
optim a see ada w m a a la w m ke the sca athing of the
istic nd y hen ore dvnced sers ill a lpel
past.
5. • T second of these v s ma prov to be the most a te, for surgica use of
he iew y e ccura l
la is ra a a . Afirst, la w considered m effectiv in
sers pidly dvncing t sers ere ost e
opera on a s tha a ea to rea rea on the body exterior, including the
ting rea t re sy ch—a s 's
skin, m nose, ea a ey B in recent y rs doctors hae dem ted
outh, rs, nd es. ut ea v onstra
rem rka prog in dev
a ble ress eloping la techniques for use in interna explora
ser l tion
a surg . O course, in order to be a to direct the la bea the doctor m
nd ery f ble ser m ust
be a to see inside the body In som ca this is asim m tter of m king a
ble . e ses ple a a n
incision a opening up the a to be opera on. B there a situa in w
nd rea ted ut re tions hich
this step ca be aoided.
n v
6. Cl eani ng A r ter i es wi th L i ght
• F insta la a increa lyused to clea pla frompeople's a . P que is atough fa substa tha
or nce, sers re sing n que rteries la tty nce t
ca build up on the inside wlls of the a . Eentua the v ca g so clog ed tha blood does not flow
n a rteries v lly essels n et g t
norm lly a the result ca be ahea a ck or stroke, both of w a serious a som es fa l. T tra l
a , nd n rt tta hich re nd etim ta he ditiona
m for rem ing the pla inv es opening the chest a m king sev l incisions, along a som es risky
ethod ov que olv nd a era nd etim
opera . It is a expensiv a requires w for recov .
tion lso e nd eeks ery
• A effectiv a tiv is to use ala bea to burn a a the pla . T keyto ma this w is the doctor's
n e lterna e ser m wy que he king ork
a to see inside the a a direct the bea , a
bility rtery nd m nother a in w fiber optics a la a com into a
rea hich nd sers re bined
m w tool. A optic fiber tha ha been connected to atinytelev ca eraca be inserted into a a .
odern onder n t s ision m n n rtery
T elem nowbecom am ture sensor tha a s the doctor a nurses to see inside the a w asecond
hese ents e inia t llow nd rtery hile
fiber is inserted to ca the bursts of lig tha w burn a a the pla .
rry ht t ill wy que
• T technique w in the follow wy T fiber- a yis inserted into ablood v in a a or leg a
he orks ing a. he optic rra essel n rm nd
m ed slow into the a of the hea a blocked a . W the a yis in pla the la is fired a the
ov ly rea rt nd rteries hen rra ce ser nd
pla destroy a then the exha vpors a sucked ba throug atinyhollowtube tha is inserted a w
que ed, nd ust a re ck h t long ith
the optica fibers. W the a ha been clea out the doctor rem es the fibers a tube, a the opera is
l hen rtery s ned ov nd nd tion
finished. T m l process is know a la a iopla . It ha sev l obv a a g . F no incision is needed
his edica n s ser ng sty s era ious dvntaes irst,
(except for the sm ll one in the v to insert the fibers) T is a little or no bleeding a the pa ca
a essel . here lso , nd tient n
enjoytota recov in ada or tw.
l ery y o
• Lser a iopla does hae some potentia risks tha must be considered. F w the la bea fires a the pla
a ng sty v l t irst, hen ser m t que
it m be a ed v ca
ust im ery refullybeca aslig m could cut throug the wll of the a a ca serious
use ht iss h a rtery nd use
bleeding T pa chest w then hae to be opened up a a . A problem inv es sm ll pieces of burnt
. he tient's ould v fter ll nother olv a
debris fromthe
7. • Surgeons useatiny laser tocutaway tissuein agallbladder operation.
The laser and atiny c era are insert intothe navel, so noabdom
am ed inal
incision is necessary.
• destroy pla . If these enter the bloodstrea , theyca ca blockae in sm ller
ed que m n use g a
blood v bring further com tions. F tely continuous technica
essels, ing plica ortuna , l
a a ents hae considera reduced these risks, a the num of successful la
dvncem v bly nd ber ser
a iopla perform is increa ea y r.
ng sties ed sing ch ea
8. L aser s H eal and R eshape the E yes
• S e of the most rema ble brea hs for medica la hae been in the a
om rka kthroug l sers v rea
of ophtha olog , the studyof the structure a disea of the ey. O rea tha
lm y nd ses e ne son t
la bea s a so useful in trea the ey is tha the cornea the coa tha
ser m re ting e t , ting t
cov the ey ll a a its lig into the interior of the ey is tra rent. S
ers eba nd dm ht e, nspa ince
it is desig to a it ordina lig the cornealets in la lig just a w a
ned dm ry ht, ser ht s ell nd
rem ins una
a ffected bythe bea . m
• F the la is v useful in rem ing extra blood v tha ca formon
irst, ser ery ov neous essels t n
the retina thin, lig - e m bra a the ba of the ey ll. It is on the
—the htsensitiv em ne t ck eba
retinatha the im g of the thing the ey sees a form . D m g to the retinaca
t aes s e re ed a ae n
som es ca blindness, the m com on formin the U S tes resulting from
etim use ost m nited ta
dia ( disea cha cterized byhig lev of blood sug r) w in som a a
betes a se ra h els a hen, e dvnced
ca hundreds of tinyextrablood v formon the retina T block lig from
ses, essels . hese ht
the surfa of the m bra resulting in pa l or tota blindness.
ce em ne, rtia l
9. • T la most often used in the trea ent of this condition is pow byamediumof
he ser tm ered
a on g s. T doctor a s the bea throug the corneaa burns a a the ta le of blood
rg a he im m h nd wy ng
v cov the retina T procedure ta onlyafewm a ca be done in the
essels ering . he kes inutes nd n
doctor's office. T la ca a repa adeta retina tha ha broken loose from
he ser n lso ir ched —one t s
the rea pa of the ey ll. B the a ent of la deta retina ha to be
r rt eba efore dv sers ched s d
repa byha a beca the retinais so delica this ws av difficult opera to
ired nd, nd use te a ery tion
perform U the a on la the doctor ca a lly"w " the torn retinaba in
. sing rg ser, n ctua eld ck
pla . It is perha astra e coincidence tha G G one of the orig l inv
ce ps ng t ordon ould, ina entors
of the la la ha one of his ow retina repa this wy
ser, ter d n s ired a.
• A condition tha a the ey is gla a w is cha cterized bythe buildup of
nother t ffects e ucom , hich ra
fluid in the ey. N a the ey na l fluids dra a a alittle a atim a the ey
e orm lly e's tura in wy t e, nd e
stas hea . In ey im ired w g ucom the fluid does not dra properly a the
y lthy es pa ith la a in , nd
buildup a v blindness ca som es result. In som ca drug ca be used to
ffects ision; n etim e ses s n
trea g ucom . If the drug fa how er, m nydoctors nowturn to the la to aoid
t la a s il, ev a ser v
conv l surg . T la punches ahole in aprepla spot a the fluid dra out
entiona ery he ser nned nd ins
throug the hole. Aa the trea ent ca be perform in adoctor's office instea of a
h g in, tm n ed d
hospita.l
10. Usi ng L aser s for E ye Sur ger y
• T la w like asew ma to repa adeta retina the membra tha
he ser orks ing chine ir ched , ne t
lines the interior of the ey. T la bea is a
e he ser m djusted so tha it ca pa
t n ss
ha lesslythroug the lens a focus on tinyspots a the da aed a of the
rm h nd round m g rea
retina W it is focused, the bea ha the intensityto "w " or sea the deta
. hen m s eld l ched
a of the retinaba aa the wll of the ey ll.
rea ck g inst a eba
• P ps m exciting of a the ey- ted la a tions is the resha of the
erha ost ll erela ser pplica ping
ey cornea atechnique w know a LS ( hich sta for L a -A ssisted
e's , idely n s A wIK nds ser
I n S itu K era ilensis) AB H describes it,
tom . s reck itz
11. • T pa ey la prescription is litera ca ed inside the corneaw the bea of a excimer
he tient's eg ss lly rv ith m n
la [ala dev tha produces pulses of ultraiolet, or U, lig ]. A a fla of the cornea
ser ser ice t v V ht sm ll p
is first rem ed w aprecision knife . . . a a
ov ith nd n
A pa underg ey surg perform byala bea . In
tient oes e ery ed ser m
a
ddition to trea deta retina la ca rem e ca ra
ting ched s, sers n ov ta cts.
inner portion of the corneais exposed to the excim la A
er ser. fter
the prescription is ca ed, the cornea fla tha ws opened is
rv l p t a
then put ba into pla ov the a ted [surg llya
ck ce er bla ica ltered]
cornea 6
.
LS does not com w risks. T cha es it m kes in the
A IK e ithout he ng a
corneaa perm nent, a the da er of unexpected da ae is ev
re a nd ng m g er
present. H ev the procedure ha becom increa lypopula
ow er, s e sing r
ea y r; a am Aerica ha it done in the y r 20,
ch ea bout illion m ns d ea 00
a a four thousa surg in the U S tes w tra
nd bout nd eons nited ta ere ined
to perform it.
12. Some Cosmeti c Uses of L aser s
• M l la a a w used for vrious ty of cosmetic surgery including
edica sers re lso idely a pes ,
the rem a of certa kinds of birthm rks. P w sta reddish purple skin
ovl in a ort- ine ins,
blotches tha a r on a three out of ev one thousa children, a a
t ppea bout ery nd re n
exa ple. S sta ca m rk a pa of the bodybut a m com onlyfound on
m uch ins n a ny rt re ost m
the fa a neck.
ce nd
• T m l la is a to rem e aport- ine sta for the sa e rea tha a
he edica ser ble ov w in m son t
m ryla is a to fla am g to asubm ed subm rine. B la ta
ilita ser ble sh essae erg a oth sers ke
a a g of the m
dvntae onochrom tic qua of la lig tha is, its a to shine
a lity ser ht, t bility
in one specific color. T sta is m de up of thousa of tinym lform blood
he in a nds a ed
v tha hae adefinite reddish purple color. T color v strong a
essels t v his ery ly bsorbs a
certa sha of g lig In fa tha is w the sta looks red. It a
in de reen ht. ct, t hy in bsorbs the
g a other colors in w lig but reflects the red ba to people's ey
reen nd hite ht ck es.
13. • S a exa ple of ala a cosmetic procedure is the removl of
till nother m ser-ssisted a
unwnted ha "T la em ag bea of lig expla C g cosm
a ir. he ser its entle m ht," ins hicao etic
surg J M
eon effrey elton,
• w onlyis a
hich bsorbed in the ha follicle ( v the skin unha ed) T la
ir leaing rm . he ser
deliv energ w is a
ers y hich bsorbed in the ha a tra ed to hea T hea
ir nd nsform t. he t
destroy the ha follicle w asm ll fra of asecond. . . . Lser ha
s ir ithin a ction a ir
rem a is g for both fa l ha rem a a for bodyha rem a . . .
ovl ood cia ir ovl nd ir ovl.
P ps the m com onlytrea a s a fa l ha in w en. 7
erha ost m ted rea re cia ir om
14. • T trea the sta the doctor runs aw lowpow bea of green light a the
o t in, ide - er m cross
discolored a . T m ss of blood v in the sta a
rea he a essels in bsorbs the energ la lig a
etic ser ht nd
becom so hot tha it is a llyburned a a. T surrounding skin is adifferent color
es t ctua wy he
tha the sta so tha skin a
n in, t bsorbs onlysm ll a ounts of the bea a rem ins unburned.
a m m nd a
( f course, the burned
O
• A doctor uses an argon laser toremoveaport-winestain, akind of
birthmark. Unw anted tissueis burned aw w normal skin remains
ay hile
undamaged.
• a s must hea a during this process some minor sca sometimes occurs.) Asimila
rea l, nd rring r
m is often successful in rem ing ta A ttoo is form w v strong dy
ethod ov ttoos. ta ed hen ery es
a injected w needles into aperson's skin. S eone w ha been ta
re ith om ho s ttooed m ydecide
a
la in life tha he or she does not wnt the ta a m a in the pa the only
ter t a ttoo ny ore; nd st,
wyto rem e these desig inv ed surg or burning off the ta w a L ,
a ov ns olv ery ttoo ith cid. uckily
the la offers a a tiv to such extrem m sures. T bea blea the dy in the
ser n lterna e e ea he m ches es
ta w burning the surrounding skin. ( s in the ca of port- ine sta som lig
ttoo ithout A se w ins, e ht
sca is possible.)
rring
15. L aser -A ssi sted D enti str y
• Dentistryis a bra of medicine tha ha benefited tremendouslyfromla
nother nch t s ser
technolog . Indeed, la hae m de som people stop drea av to the dentist.
y sers v a e ding isit
N one enjoy haing acaitydrilled, of course. It usua requires a a
o s v v lly n nesthetic (a
pa inkiller like nov ine) tha ca uncom ble num in the m a the
oca t uses forta bness outh; lso,
sound of the drill ca be irrita or ev sickening to som people.
n ting en e
• Mnydentists nowemploya N-A la (w uses acry l for its la medium)
a n d YG ser hich sta sing
instea of adrill for m caities. T la trea ent ta a a g of the
d ost v he ser tm kes dvntae
sim fa tha the m teria tha form in acaityis m softer tha the ena el
ple ct t a l t s v uch n m
( ha pa of atooth) T la is set a apow tha is just strong enoug to
the rd rt . he ser t er t h
elim te the decaed tissue but not strong enoug to ha the ena el. W trea
ina y h rm m hen ting
av deep caitybleeding som es occurs, a the la bea often sea off
ery v etim nd ser m ls
blood v a stops the bleeding
essels nd .
16. • T most often a question a trea caities w la is: Does it hurt?T
he sked bout ting v ith sers he
a er is no. Ech burst of la lig fromadenta la la onlythirty
nsw a ser ht l ser sts -
trillionths of asecond, m fa tha the a ount of tim anerv ta to trig er
uch ster n m e e kes g
pa . In other w the bea w hae to la 10 m tim long in order
in ords, m ould v st 0 illion es er
to ca a discom . S this sort of trea ent requires no a
use ny fort o tm nesthetic.
• T a litera hundreds of other m l uses for the la . S num
here re lly edica ser till, erous
m l conditions ca be helped byla lig . A ev in those tha do respond
edica nnot ser ht nd en t
to la trea ents, adoctor m yhae ag rea for choosing adifferent m
ser tm a v ood son ethod
in aspecific ca . T pla fa is tha w the la is am rv m l tool,
se he in ct t, hile ser a elous edica
it ca cure ev ill. Y the w ha seen proba onlyasm ll fra of the
nnot ery et orld s bly a ction
la potentia. A a this supertool ha onlyexisted since 190 a considering
ser's l fter ll, s 6, nd,
the m l a a it a dyha crea the future a rs prom indeed.
edica dvnces lrea s ted, ppea ising
17. A a g of Lsers for D l S ery
dvntaes a enta urg
• In this excerpt froma a in TheDental Clinics of N orth A merica
n rticle
R AS uss of the M l C e of V iniam
obert . tra edica olleg irg entions som of the a a g
e dvntaes
of using la for ora surg .
sers l ery
• D sed post- tiv sw is cha cteristic of la use [for ora surg ].
ecrea opera e elling ra ser l ery
D sed sw a s for increa sa w perform surg w the
ecrea elling llow sed fety hen ing ery ithin
a a [the m ] . . . a increa the ra e of surg tha ora surg ca
irwy outh nd ses ng ery t l eons n
performsa w fea of a a com ise. T effect a s the surg to
fely ithout r irwy prom his llow eon
performm nyprocedures in a office or outpa fa tha prev w
a n tient cility t iously ould
hae required hospita tion. . . . T hea a sca a a im ed
v liza issue ling nd rring re lso prov
w the use of the la . . . . Lser w g llyhea w m a sca
ith ser a ounds enera l ith inim l r
form tion a . . . often ca be left unsutured [w stitches], a
a nd n ithout nother distinct
aa g
dvntae
