The Carbon Dioxide Laser in Clinical Surgery

Abstract

Experimental work with the CO₂ laser (Stellar et al., 1971a,b; Gonzalez et al., 1970; Goodale et al., 1970; Hall et al., 1971; Hall, 1971a,b; Kaplan and Ger, 1973) has led to the hypothesis that if the laser beam were to fulfill expectations it should be possible to excise or incise tissues without damage to adjacent tissue, while at the same time reducing bleeding to a minimum by sealing off at least all minor blood vessels. If this were so, then the following advantages would be immediately evident:

• 1. Blood loss would be reduced to a mimimum, thus reducing the requirement for blood replacement with its associated risks, such as incompatibility and virus infection. (The economic burden of acquiring and processing donor blood should not be underestimated.)

• 2. The operating time would be reduced by eliminating ligation of most bleeding points.

• 3. The reduction of the amount of necrotic tissue and hematoma formation in the wound would lead to a diminished infection rate.

• 4. In the event of existing sepsis, the laser beam would tend to sterilize the wound.

• 5. Wound healing would not be delayed, but might even be enhanced due to a combination of the above factors.

• 6. With the sealing off of vessels, the possible spread of malignant cells during extirpative surgery for malignant disease would be reduced to a minimum and, additionally, primary repair of the defect would not be precluded.