Laser medicine
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Laser medicine is the use of
laser A laser is a device that emits light through a process of optical amplification based on the stimulated emission of electromagnetic radiation. The word ''laser'' originated as an acronym for light amplification by stimulated emission of radi ...
s in
medical diagnosis Medical diagnosis (abbreviated Dx, Dx, or Ds) is the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as a diagnosis with the medical context being implicit. The information ...
, treatments, or therapies, such as laser photodynamic therapy, photorejuvenation, and
laser surgery Laser surgery is a type of surgery that cuts tissue using a laser in contrast to using a scalpel. Soft-tissue laser surgery is used in a variety of applications in humans ( general surgery, neurosurgery, ENT, dentistry, orthodontics, and ...
. The word ''laser'' stands for "light amplification by stimulated emission of radiation".


History

The laser was invented in 1960 by Theodore Maiman, and its potential uses in medicine were subsequently explored. Lasers benefit from three interesting characteristics: directivity (multiple directional functions), impulse (possibility of operating in very short pulses), and monochromaticity. Several medical applications were found for this new instrument. In 1961, just one year after the laser's invention, Dr. Charles J. Campbell successfully used a ruby laser to destroy an angiomatous retinal tumor with a single pulse. In 1963, Dr. Leon Goldman used the ruby laser to treat pigmented skin cells and reported on his findings. The argon-ionized laser (wavelength: 488–514 nm) has since become the preferred laser for the treatment of retinal detachment. The
carbon dioxide laser The carbon-dioxide laser (CO2 laser) was one of the earliest gas lasers to be developed. It was invented by C. Kumar N. Patel, Kumar Patel of Bell Labs in 1964 and is still one of the most useful types of laser. Carbon dioxide, Carbon-dioxide lase ...
was developed by Kumar Patel and others in the early 1960s and is now a common and versatile tool not only for medicinal purposes but also for welding and drilling, among other uses. The possibility of using
optical fiber An optical fiber, or optical fibre, is a flexible glass or plastic fiber that can transmit light from one end to the other. Such fibers find wide usage in fiber-optic communications, where they permit transmission over longer distances and at ...
(over a short distance in the operating room) since 1970 has opened many laser applications, in particular endocavitary, thanks to the possibility of introducing the fiber into the channel of an
endoscope An endoscope is an inspection instrument composed of image sensor, optical lens, light source and mechanical device, which is used to look deep into the body by way of openings such as the mouth or anus. A typical endoscope applies several modern ...
. During this time, the argon laser began to be used in
gastroenterology Gastroenterology (from the Greek gastḗr- "belly", -énteron "intestine", and -logía "study of") is the branch of medicine focused on the digestive system and its disorders. The digestive system consists of the gastrointestinal tract, sometime ...
and pneumology. Dr. Peter Kiefhaber was the first to "successfully perform endoscopic argon laser photocoagulation for gastrointestinal bleeding in humans". Kiefhaber is also considered a pioneer in using the Nd:YAG laser in medicine, also using it to control gastrointestinal bleeding. In 1976, Dr. Hofstetter employed lasers for the first time in
urology Urology (from Ancient Greek, Greek wikt:οὖρον, οὖρον ''ouron'' "urine" and ''wiktionary:-logia, -logia'' "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of t ...
. The late 1970s saw the rise of photodynamic therapy, thanks to laser dye. (Dougherty, 1972) Since the early 1980s, applications have particularly developed, and lasers have become indispensable tools in ophthalmology, gastroenterology, and facial and aesthetic surgery. In 1981, Goldman and Dr. Ellet Drake, along with others, founded the American Society for Laser Medicine and Surgery to mark the specialization of certain branches of medicine thanks to the laser. In the same year, the Francophone Society of Medical Lasers (in French, Société Francophone des Lasers Médicaux) was founded for the same purpose and was first led by Maurice Bruhat. After the end of the 20th century, a number of centers dedicated to laser medicine opened, first in the OCDE, and then more generally since the beginning of the 21st century. The Lindbergh Operation was a historic surgical operation between surgeons in New York (United States) and doctors and a patient in Strasbourg (France) in 2001. Among other things, they utilized lasers.


Advantages

The laser presents multiple unique advantages that make it very popular among various practitioners. * Due to its directional precision, a laser precisely cuts and cauterizes tissues without damaging neighboring cells. It's the safest technique and most precise cutting and cauterizing ever practiced in medicine. * Laboratories use lasers extensively, especially for spectroscopy analysis and more generally for the analysis of biochemical samples. It makes it possible to literally "see" and more quickly determine the composition of a cell or sample on a microscopic scale. * The electrical intensity of a laser is easily controllable in a safe way for the patient but also variable at will, which gives it a very wide and still partially explored range of uses (in 2021).


Disadvantages

The principal disadvantage is not medical but rather economic: its cost. Although its price has dropped significantly in developed countries since its inception, it remains more expensive than most other common technical means due to materials, the technicality of the equipment necessary for the operation of any laser therapy, and the fact that it requires only certain specific training. For example, in France (as in other countries with a social security system), dental, endodontal or periodontal laser treatment is classified outside the nomenclature and not reimbursed by social security.


Lasers

Lasers used in
medicine Medicine is the science and Praxis (process), practice of caring for patients, managing the Medical diagnosis, diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, ...
include, in principle, any type of laser, but especially the following: * CO2 lasers, used to cut, vaporize, ablate, and photocoagulate soft tissue. * diode lasers * dye lasers * excimer lasers * fiber lasers * gas lasers * free electron lasers * semiconductor diode lasers


Applications in medicine

Examples of procedures, practices, devices, and specialties where lasers are utilized include the following: *
angioplasty Angioplasty, also known as balloon angioplasty and percutaneous transluminal angioplasty, is a minimally invasive procedure, minimally invasive endovascular surgery, endovascular Medical procedure, procedure used to widen narrowed or obstructe ...
*
cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...
diagnosis * cancer treatment *
dentistry Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the Human tooth, teeth, gums, and Human mouth, mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, dis ...
* cosmetic dermatology such as scar revision, skin resurfacing, laser hair removal, and tattoo removal *
dermatology Dermatology is the branch of medicine dealing with the Human skin, skin.''Random House Webster's Unabridged Dictionary.'' Random House, Inc. 2001. Page 537. . It is a speciality with both medical and surgical aspects. A List of dermatologists, ...
, to treat melanoma * frenectomy * gingivectomy * lithotripsy *laser mammography *
medical imaging Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to revea ...
*
microscopy Microscopy is the technical field of using microscopes to view subjects too small to be seen with the naked eye (objects that are not within the resolution range of the normal eye). There are three well-known branches of microscopy: optical mic ...
*
ophthalmology Ophthalmology (, ) is the branch of medicine that deals with the diagnosis, treatment, and surgery of eye diseases and disorders. An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a ...
(includes
Lasik LASIK or Lasik (; "laser-assisted in situ keratomileusis"), commonly referred to as laser eye surgery or laser vision correction, is a type of refractive surgery for the correction of myopia, hyperopia, and astigmatism. LASIK surgery is p ...
and laser photocoagulation) * optical coherence tomography *
optogenetics Optogenetics is a biological technique to control the activity of neurons or other cell types with light. This is achieved by Gene expression, expression of Channelrhodopsin, light-sensitive ion channels, Halorhodopsin, pumps or Photoactivated ade ...
*
prostatectomy Prostatectomy (from the Ancient Greek language, Greek , "prostate" and , "excision") is the surgical removal of all or part of the prostate gland. This operation is done for benignity, benign conditions that cause urinary retention, as well as ...
* plastic surgery, in laser liposuction, in the treatment of skin lesions (congenital and acquired), and in scar management (burns and surgical scars) *
surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...
, to cut, ablate, and cauterize tissue


See also

* Dental laser * Endovenous laser therapy * Laser-assisted new attachment procedure *
Laser surgery Laser surgery is a type of surgery that cuts tissue using a laser in contrast to using a scalpel. Soft-tissue laser surgery is used in a variety of applications in humans ( general surgery, neurosurgery, ENT, dentistry, orthodontics, and ...
* Light therapy * Low level laser therapy * Neuromodulation * Neurostimulation * Photodynamic therapy * Photomedicine


References


External links

{{DEFAULTSORT:Laser Medicine Laser applications Medical physics