Basics of Laser Resection in Parenchymatous Organs

Abstract

With the development of modern medical lasers, the role of laser therapy is increasing in the wide spectrum of treatment modalities. In oncology, laser techniques have also become interesting alternatives to radical tumor resection and to palliative tumor treatment methods. Due to the great variability of induced tissue reactions, from microsurgically precise coagulation and cutting to voluminous coagulation or tumor vaporization, the Nd:YAG laser (wavelength 1064 nm) is the most important surgical laser. The possibility of transmitting its light through flexible fibers allows specific application. The longest-term experience exists with all applications of voluminous coagulation for hemostasis and tumor destruction. For the first time, microsurgical preparation with the Nd:YAG laser became possible with the introduction of contact surgery with sapphire tips [1]. The great disadvantages of sapphire tips in practical use led us to introduce bare fiber contact surgery in 1983. Due to the easy handling and low cost of the bare fiber method, this is at present our standard method for all contact applications, especially in endoscopic procedures [2]. Due to the fact that light in the near-infrared range has the greatest penetration depth in tissue, it is also possible to produce homogeneous coagulation during the direct irradiation of the diseased area by the fiber introduced percutaneously into the tissue to be treated.