The Use of Contact Laser in Neurosurgery. Clinical and Experimental Data

Abstract

Recent technological improvements have resulted in the introduction of contact probes which have improved laser fiberoptic delivery system and substances able to transmit laser light. The sapphire tips introduced by Daikuzono and Joffe in 1985 [1] are currently used to deliver more than 90% of laser light, causing no tissue adhesion phenomena. This is an artificial crystal which is hard enough and has enough mechanical resistance to prevent breaking of the tip. Lateral irradiation, which results in 30–40% of the total power delivered in non-contact probes, is avoided, thus providing substantial reduction in laser energy requirements. The contact tips are so efficient that very low thermal energy is required for a sharp incision, because of such rapid tissue vaporization. The greater divergence of the beam limits the thermal effect, thereby minimizing the lesion. The contact probes are suitable for both freehand and endoscopic application.