Laser Therapy
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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 Photodynamic therapy (PDT) is a form of phototherapy involving light and a photosensitizing chemical substance used in conjunction with molecular oxygen to elicit cell death ( phototoxicity). PDT is used in treating acne, wet age-related macula ...
,
photorejuvenation Photorejuvenation is a skin treatment that uses lasers, intense pulsed light, or photodynamic therapy to treat skin conditions and remove effects of photoaging such as wrinkles, spots, and textures. The process induces controlled wounds to the ski ...
, 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 A ruby laser is a solid-state laser that uses a synthetic ruby crystal as its gain medium. The first working laser was a ruby laser made by Theodore H. "Ted" Maiman at Hughes Research Laboratories on May 16, 1960. Ruby lasers produce pulses of ...
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 Retinal detachment is a condition where the retina pulls away from the tissue underneath it. It may start in a small area, but without quick treatment, it can spread across the entire retina, leading to serious vision loss and possibly blindness. ...
. 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 Photodynamic therapy (PDT) is a form of phototherapy involving light and a photosensitizing chemical substance used in conjunction with molecular oxygen to elicit cell death ( phototoxicity). PDT is used in treating acne, wet age-related macula ...
, 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 laser The laser diode chip removed and placed on the eye of a needle for scale A laser diode (LD, also injection laser diode or ILD or semiconductor laser or diode laser) is a semiconductor device similar to a light-emitting diode in which a diode p ...
s *
dye laser A dye laser is a laser that uses an organic dye as the lasing medium, usually as a liquid solution. Compared to gases and most solid state lasing media, a dye can usually be used for a much wider range of wavelengths, often spanning 50 to 100 n ...
s * excimer lasers *
fiber laser A fiber laser (or fibre laser in Commonwealth English) is a laser in which the active gain medium is an optical fiber doped with rare-earth elements such as erbium, ytterbium, neodymium, dysprosium, praseodymium, thulium and holmium. They ar ...
s *
gas laser A gas laser is a laser in which an electric current is discharged through a gas to produce coherent light. The gas laser was the first continuous-light laser and the first laser to operate on the principle of converting electrical energy to a las ...
s * free electron lasers *
semiconductor diode laser The laser diode chip removed and placed on the eye of a needle for scale A laser diode (LD, also injection laser diode or ILD or semiconductor laser or diode laser) is a semiconductor device similar to a light-emitting diode in which a diode p ...
s


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 Cancer treatments are a wide range of treatments available for the many different types of cancer, with each cancer type needing its own specific treatment. Treatments can include surgery, chemotherapy, radiation therapy, hormonal therapy, targ ...
*
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 Laser hair removal is the process of hair removal by means of exposure to pulses of laser light that destroy the hair follicle. It had been performed experimentally for about twenty years before becoming commercially available in 1995–1996. One ...
, and
tattoo removal Tattoo removal is a procedure to eliminate or significantly lighten a tattoo from the skin. People pursue removal for many reasons, including changes in personal taste, social or professional considerations, or a desire to relocate a tattoo. Mo ...
*
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 A frenectomy is the removal of a frenulum, a small fold of tissue that prevents an organ in the body from moving too far. It can refer to frenula in several places on the human body. It is related to frenuloplasty, a surgical alteration in a f ...
*
gingivectomy Gingivectomy is a dental procedure in which a dentist or oral surgeon cuts away part of the gums in the mouth (the ''gingiva''). It is the oldest surgical approach in periodontal therapy and is usually done for improvement of aesthetics or progn ...
*
lithotripsy Lithotripsy is a procedure involving the physical destruction of hardened masses like kidney stones, bezoars or gallstones, which may be done non-invasively. The term is derived from the Greek words meaning "breaking (or pulverizing) stones" ( lit ...
*laser
mammography Mammography (also called mastography; DICOM modality: MG) is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cance ...
*
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 Laser coagulation or laser photocoagulation surgery is used to treat a number of eye diseases and has become widely used in recent decades. During the procedure, a laser is used to finely cauterize ocular blood vessels to attempt to bring about v ...
) *
optical coherence tomography Optical coherence tomography (OCT) is a high-resolution imaging technique with most of its applications in medicine and biology. OCT uses coherent near-infrared light to obtain micrometer-level depth resolved images of biological tissue or oth ...
*
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 A dental laser is a type of laser designed specifically for use in oral surgery or dentistry. In the United States, the use of lasers on the gums was first approved by the Food and Drug Administration in the early 1990s, and use on hard tissue like ...
* 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 Light therapy, also called phototherapy or bright light therapy is the exposure to direct sunlight or artificial light at controlled wavelengths in order to treat a variety of medical disorders, including seasonal affective disorder (SAD), circ ...
*
Low level laser therapy Low-level laser therapy (LLLT), cold laser therapy or photobiomodulation (PBM) is a medical treatment approach that applies low-level (low- power) lasers or light-emitting diodes (LEDs) to the surface of the body. Whereas high-power lasers are ...
*
Neuromodulation Neuromodulation is the physiological process by which a given neuron uses one or more chemicals to regulate diverse populations of neurons. Neuromodulators typically bind to metabotropic, G-protein coupled receptors (GPCRs) to initiate a sec ...
*
Neurostimulation Neurostimulation is the purposeful modulation of the nervous system's activity using invasive (e.g. microelectrodes) or Non-invasive procedure, non-invasive means (e.g. transcranial magnetic stimulation, transcranial electric stimulation such as ...
*
Photodynamic therapy Photodynamic therapy (PDT) is a form of phototherapy involving light and a photosensitizing chemical substance used in conjunction with molecular oxygen to elicit cell death ( phototoxicity). PDT is used in treating acne, wet age-related macula ...
*
Photomedicine Photomedicine is an interdisciplinary branch of medicine that involves the study and application of light with respect to health and disease. Photomedicine may be related to the practice of various fields of medicine including dermatology, surgery, ...


References


External links

{{DEFAULTSORT:Laser Medicine Laser applications Medical physics