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 it cuts through or vaporizes tissue.
• Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. Capable of penetrating tissue more deeply than other lasers, the Nd:YAG makes blood clot quickly and can enable surgeons to see and work on parts of the body 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 diverse array of procedures that:

• Improve appearance
• Relieve pain
• Restore function
• Save lives.

Laser surgery is often standard operating procedure for specialists in:

• Cardiology
• Dentistry
• Dermatology
• Gastroenterology (treatment of disorders of the stomach and intestines)
• Gynecology
• Neurosurgery
• 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)
• Pulmonary care (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 erasing birthmarks, skin discoloration, and skin changes due to aging, and removing benign, precancerous, or cancerous tissues or tumors. Lasers are used to stop 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 non-cancerous 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
• Non-cancerous enlargement of the prostate gland
• Nosebleeds
• Ovarian cysts
• Ulcers
• Varicose veins
• Warts
• And 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, Inc. 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 be available whenever laser surgery is performed in a non-hospital setting.

Imprecisely aimed lasers can burn or destroy healthy tissue.

Books

• Carlson, Karen J., et al. The Harvard Guide to Women's Health. Cambridge, Massachusetts: Harvard University Press, 1996.

Periodicals

• "Laser Procedures for Nearsightedness." FDA Consumer (Jan./Feb. 1996): 2.

• "Laser Resurfacing Slows the Hands of Time." Harvard Health Letter (Aug. 1996): 4-5.

• "Lasers." Mayo Clinic Health Letter (July 1994): 1-3.

• "Lasers: Bright Lights of the Medical World." Cosmopolitan , May 1995, 262-265.

• "Lasers for Skin Surgery." Harvard Women's Health Watch (Mar. 1997): 2-3.

• "Lasers -- Hope or Hype?" American Health (June 1994): 68-72, 103.

• "The Light Fantastic." Helix (Winter 1989): 3-9.

• "New Cancer Therapies That Ease Pain, Extend Life." Cancer Smart (June 1997): 8-10.

• "New Laser Surgery for Angina." HealthNews (6 May 1997): 3-4.

• "Saving Face." Essence , Aug. 1997, 24, 26, 28.

• "Under the Gun." Mirabella , Jan./Feb. 1996, 108-110.

• "What a Laser Can and Cannot Do." San Jose Mercury News , Feb. 1994, 22, 24.

Organizations

• American Society for Dermatologic Surgery. 930 N. Meacham Road, P.O. Box 4014, Schaumburg, IL 60168-4014. (847) 330-9830. http://www.asds-net.org

• American Society for Laser Medicine and Surgery. 2404 Stewart Square, Wausau, WI 54401.(715) 845-9283. http://www.aslms.org

• Cancer Information Service. 9000 Rockville Pike, Building 31, Suite 10A18, Bethesda, MD 20892. 1-800-4-CANCER. http://wwwicic.nci.nih.gov.7.

• National Cancer Institute. Building 31, Room 10A31, 31 Center Drive, MSC 2580, Bethesda, MD 20892-2580. (800) 422-6237. http://www.nci.nih.gov

Other

• Haggerty, Maureen. "ASLMS Guidelines for Office-Based Laser Procedures." A Healthy Me Page. 19 Mar. 1998 http://www.ahealthyme.com/topic/topic100587070

• "Facts About Laser Surgery." Glaucoma Research Foundation Page. 12 Mar. 1998 http://www.glaucoma.org/fs-laser-sur.html

• "Refractive Eye Surgery." Mayo Clinic Online. 15 Mar. 1998 http://www.mayohealth.org/mayo/9707/htm/refract.htm

• "What is Laser?" The American Society for Dermatologic Surgery Page. 19 Mar. 1998 http://www.asds-net.org

Key Terms

Term	Definition
Argon	A colorless, odorless gas.
Astigmatism	A condition in which one or both eyes cannot filter light properly and images appear blurred and indistinct.
Canker sore	A blister-like sore on the inside of the mouth that can be painful but is not serious.
Carbon dioxide	A heavy, colorless gas that dissolves in water.
Cardiopulmonary resuscitation	An emergency procedure used to restore circulation and prevent brain death to a person who has collapsed, is unconscious, is not breathing, and has no pulse.
Cauterize	To use heat or chemicals to stop bleeding, prevent the spread of infection, or destroy tissue.
Cornea	The outer, transparent lens that covers the pupil of the eye and admits light.
Endometriosis	An often painful gynecologic condition in which endometrial tissue migrates from the inside of the uterus to other organs inside and beyond the abdominal cavity.
Glaucoma	A disease of the eye in which increased pressure within the eyeball can cause gradual loss of vision.
Invasive surgery	A form of surgery that involves making an incision in the patient's body and inserting instruments or other medical devices into it.
Nearsightedness	A condition in which one or both eyes cannot focus normally, causing objects at a distance to appear blurred and indistinct. Also called myopia.
Ovarian cyst	A benign or malignant growth on an ovary. An ovarian cyst can disappear without treatment or become extremely painful and have to be surgically removed.
Vaporize	To dissolve solid material or convert it into smoke or gas.
Varicose veins	Swollen, twisted veins, usually occurring in the legs, that occur more often in women than in men.