State of the Art Surgical Laser Procedures

What is a laser?

A laser generates a highly focusable beam of light that can vaporize (cut) or seal (weld) tissue.

What is laser surgery?

In laser surgery, a highly focused laser beam efficiently vaporizes the living tissue while simultaneously sealing capillaries, small blood vessels, lymphatics, and nerve endings, with significant benefits to both patients and surgeons.

What is the most efficient soft-tissue surgical laser?

CO2 surgical laser remains the dominant soft-tissue surgical laser in human and veterinary medicine for over 30 years. The interaction of CO2 laser’s infrared laser light with living tissue provides a fundamentally different approach to surgery. The diameter and power of the laser beam may be adjusted to achieve a desired control over the tissue removal, and the laser is equally adept at excisions, ablations and incisions.

Laser surgery benefits for patients

Less Bleeding    The laser seals small blood vessels as it cuts; this enables a number of surgical procedures that are not practical with conventional scalpel.

Less Pain    The CO2 laser beam seals nerve endings and lymphatics as it cuts, resulting in less pain and edema; the patient experiences a more comfortable post-operative recovery.

Reduced risk of infection    The CO2 laser beam efficiently kills bacteria in its path, producing a sanitizing effect.

Quicker recovery time     Reduced risk of infection, less bleeding, less pain and less swelling often allow the patient a far more rapid return to normal activities after laser surgery.

Laser surgery benefits for surgeons

Unique surgical capabilities    Laser surgery advances many surgical procedures by making them simpler or by reducing risk; this enables procedures that are not practical with conventional scalpels.

Enhanced visibility of the surgical field    The laser beam seals capillaries and small blood vessels as it cuts, thereby dramatically reducing bleeding, resulting in a much drier and clearer surgical site.

Reduction of surgery time    The hemostatic effect of the laser beam and the improved visibility of the surgical field often reduce the amount of time required to perform the surgery.

Increased precision and control    The diameter of the beam may be adjusted down to a small fraction of a millimeter or expanded to address a much wider coverage. The power of the beam may set for rapid removal of relatively large tissue amounts, or adjusted to remove only one or two cell layers at a pass.

General surgery procedures:

Traumatic wound debridement, Spay, Perianal tumors, Toe Nail Lasing, Declaw (feline onychectomy), Amputations, Penile amputation, Tumor bed ablations, Ceruminous adenocarcinoma, Vaginal Fold Excision, Chemodectoma Chronic ulcer debridement and sterilization, Mast cell tumors, Colorectal tumor debulking or resection, Cranial cruciate ligament rupture debridement, Granulation tissue shaving, Cystotomy, Deep mass removal, Everted saccule resection, Vital pulpotomy, Fibrosarcoma, Graft bed preparation-infected wounds, Hemangiopericytoma, Hepatic carcinoma - hepatic lobectomy, Lipoma & Liposarcoma resections, Operculectomy, Perianal urethostomy stricture revisions, Pericardectomy, Rhabdomyxoma of flank, Subtotal prostatectomy, Tendon sheath tumors hemangiopericytoma, SCC and infiltrating lipoma, Thyroidectomy, Enterotomy, Transitional cell carcinoma of bladder, Perianal fistulas, Tumor/mass removal, Urethral prolapse resections, Dewclaw removal, Urinary bladder polyps, Vaginal tumor excisions - leiomyoma, SCC and fibrosarcoma, Castration, Anal saculectomy.

"...laser surgery offers better hemostasis and visibility, less post-operative swelling, and decreased post-operative pain. In certain procedures, better hemostasis and visibility will reduce overall surgical time."

Timothy L. Holt, DVM and Fred A Mann, DVM, MS
"Soft Tissue Application of Lasers"
Vet Clin Small Anim 32 (2002) 569-599, Elsevier Science (USA)

Dermatology surgery procedures:

Viral papillomas, Follicular cysts and tumors, Gingival hyperplasia and epulis, Hyperkeratosis of digital pads /nasal planum, Hemostasis, Malignant melanoma, Localized demodex, Acral lick granuloma ablation, Cutaneous masses: skin tags, inclusion cysts, papillomas, Epibulbar melanoma, Pigmented viral plaques, Actinic keratosis, Pinnal tumors, Feline ceruminous cystomatosis, Calcinosis circumscripta, Squamous cell carcinoma removal, Wound management (acute and chronic), Nodular sebaceous hyperplasia, Plasma cell pododermatitis.

"...the ability for the operator to control the effect of the laser beam essentially to the area that you can see with no collateral damage, has led to wide use of this laser in many areas of medicine, including veterinary dermatology ..."

David Duclos, DVM
"Lasers in Veterinary Dermatology"
Clin Small Anim 36 (2006) 15-37, Elsevier Science (USA)

Opthamology surgery procedures:

Cherry Eye, Distichia, Ectopic cilia, Lacrimal Punctotomy for Epiphora, Entropion, Meibomium Gland Excision, Eyelid tumor removal, Hemangioma removal, Scleral corneal mass removal, Keratectomy, Mast cell tumors, Squamous cell carcinoma removal, Conjunctiva treatment, Epiphora.

"The CO2 laser does have a valuable role for vaporization of eyelid masses, particularly when located adjacent to the medial canthus making scalpel excision and closure difficult; for treating diffuse eyelid papillomatosis; and for safely extending surgical margins after excision or debulking of neoplasms, such as fibrosarcoma and squamous cell carcinomaof the eyelid, limbus, or nictitans."

Margi A. Gilmour, DVM, ACVO
Vet Clin Small Anim 32 (2002) 649-672. Elsevier Science, (USA)

ENT and oral surgery procedures:

Oral mass excision, Gingivectomy/plasty Incisional Biopsy, Aural Hemotoma, Bulla curettage, Ear canal ablation, Correction of faulty ear carriage, Epulis removal, Gingival hyperplasia, Sublingual tissue, Laryngeal granuloma, Ventriculochordectomy, Laryngeal scar removal, Ear crop, Lymphocytic plasmacytic stomatitis, Nasal Hyperkeratosis, Nasal Planum Resection, Osteosarcoma of palate, Ear canal polyps, Partial mandibulctomies, Periodontal flap surgery, Partial maxillectomies, Proliferative otitis - sterilization and ablation, Laryngeal web revision, Ramulas, Salivary gland removal, Salivary mucoceles, Soft palate resection, Squamous cell carcinoma, Stenotic nares, Folds, Sublingual Sialocele, Tissue Sculpting, Acanthomastous Epulis, Tongue lesions, De-barking, Tonsillectomy, Everted laryngeal saccules, Throughing for crown impressions.

"Carbon dioxide (CO2) lasers are used in oral surgery for precisely cutting or vaporizing soft tissue with hemostasis... tissue vaporization is more efficient with the CO2 laser than with other lasers..."

Jan Bellows, DVM
"Laser Use in Veterinary Dentistry"
Vet Clin Small Anim 32 (2002) 673-692. Elsevier Science, (USA)

Avian and exotic surgery procedures:

Eyelid polyp removal, Amputation, Stripping of tendons, Avian pox lesion removal, Castration, Diptheroid membrane obstructing, Anal sac removal, Choanal opening, Fibrosarcoma removal, Vocal fold excision, Granulation tissue ablation, Histiocytoma of forepaw, Lipoma removal, Xanthoma removal, Liver mass removal, Gonadectomy, Adrenal gland removal, Constricted toe syndrome, Lymph node biopsy, Ovary ablation, Papilloma removal, Caesarian section, Renal adenocarcinoma, Sebaceous adenomas, Skin incisions, Canthoplasty for lid deformities, Synovial cell sarcoma removal, Bumblefoot, Traumatic wound debridement, Nasal polyp removal, Uterine adenocarcinoma, Hysterectomy.

"There are many benefits of the CO2 laser in exotic animal practice. Their use is limited only by the imagination."

Agnes E. Rupley, DVM and Terri Parrott-Nenezian, DVM
"The Use of Surgical Lasers in Exotic and Avian Practice"
Vet Clin Small Anim 32 (2002) 703-721. Elsevier Science (USA)