Advantages of innovative laser techniques over classic scalpel technique
Speaking about the CO2 laser, it is necessary to note its generally recognized effectiveness in soft tissue surgery. The beam of this laser with a wavelength of 10 600 nm is the most tropic to water molecules (H2O). Based on the fact that human soft tissues are 60–80% water, absorption of CO2 laser radiation in them occurs most clearly and efficiently, causing the effect of ablation, in other words, the effect of the “laser scalpel”. Soft tissue ablation is a necessary and clinically significant condition for performing various types of surgery.
Universality of the “laser scalpel” technique
The versatility of our operating department allows us to use this technique – the “laser scalpel” technique – in surgery, gynecology, plastic surgery, urology.
We highlight the features and advantages of the interaction of the “laser scalpel” with biological tissues:
there is no direct contact with the tissue, which means there is no danger of infection. The beam cannot be a carrier of viruses and bacteria (including HIV, viral hepatitis B and C). The laser incision is sterile under all conditions;
sterilization of tissue in the surgical field subjected to laser radiation treatment and the ability to work with infected tissue sites. This opportunity seems truly grandiose for surgeons;
the possibility of one-stage removal of the infected dermal cyst with the application of the primary suture, provided there is no blood loss and fear of wound hematoma;
coagulating effect of radiation, allowing to obtain almost bloodless incisions. Convenience and speed. Bloodlessness is a condition that allows the surgeon to work comfortably where necessary. From personal experience: correction of congenital and acquired deformities of the lips can be performed qualitatively and symmetrically only with a laser beam;
minimal thermal effect on the surrounding tissue and the well-known biostimulating effect of the laser determine the rapid healing of the wound and a noticeable reduction in the postoperative period.
Thanks to the innovative capabilities of modern CO2 lasers, namely modulated forms of the laser pulse, independent adjustment of the ablation depth, power and pulse length, it has become possible to make laser operations as effective and physiological as possible when working with various types of tissues and indications.
It is important to understand that the safety of the patient depends on the competence of a specialist, therefore, training doctors in laser technology is a prerequisite for using laser technology in medical practice.
As a surgeon of the classical school, I had an ambiguous relationship with the laser beam. During my professional growth, I had to work with several laser systems, however, the beginning of my conscious approach to laser surgery can be considered the moment of introduction of DEKA’s SmartXide2 laser system into the clinical practice of our CO2 Center. The choice of this system was due to its multifunctionality for different areas of medicine and the presence in it of a number of innovative capabilities that directly affect the increase in efficiency and individualization of approaches in surgical practice:
Modulated laser pulse shapes Pulse Shape Design and the possibility of their choice and change,
stepwise adjustment of the depth of ablation, the so-called stacks,
independent adjustment of laser radiation parameters: power, pulse length, distance between points, pulse shape, stacks, geometry of the scanned area, scanning order.
The first use of a CO2 laser in my practice is the removal of benign skin formations. The use of the laser system has given undeniable advantages, including simplicity and speed of the process, clear visualization of the edge of the formation, the ability to work on any part of the body, including the mucous membranes and the moving part of the eyelid, aesthetics of the result, quick healing.
The disadvantage of laser exposure can be considered difficulty in taking a biopsy.
Thus, laser exposure can be considered the most acceptable way to remove benign tumors.
The use of a SmartXide2 DOT laser to remove subcutaneous formations such as atheroma, fibroma, etc., is also effective. The laser beam allows for precise dissection of skin layers. Cyst membranes are well visualized. This method is indispensable in the presence of perifocal inflammation and increased bleeding due to plethora of tissues. In all these cases, the formation was completely removed, the postoperative wound was marked by dryness, lack of bleeding, including capillary. In all cases, wounds were sutured without drainage. Antibiotic therapy was prescribed. On control examinations, positive dynamics was noted, wound healing by primary intention.