An Intelligent Surgical Laser — Science Fiction or a Pathbreaker for Future Technical Developments?

Abstract

A basic disadvantage of all laser preparation techniques, one which is common to all endoscopic preparation techniques used in surgical intervention, cannot be denied: the subjective control of the energy output by the constant energy emission from the preparation instrument. During contact preparation the energy output is preset at a constant level and must be preselected by the surgeon, as is the case with all electrosurgical and laser surgical preparation techniques. The output cannot be influenced by tissue-specific properties or by the extremely irregular surface configuration of the tissue often encountered in microsurgery. Contact laser preparation has further shown that application of laser without direct tissue contact can result in an overheating of the distal quartz fibers until they smoulder, even up to a point where the blazing hot, distal quartz glass tip falls off.