http

://w

ww.

star

trek.

com

A.A

shki

n, P

hys.R

ev.L

ett.

24, 1

56 (1

970)

A.A

shki

n et

al.

Opt

. Let

t. 11

, 288

(198

6)

http

://w

ww.

ipas

s.net

/bria

nrod

r/tw

eeze

rs.h

tml

Ash

kin,

Pro

c. N

atl.

Aca

d. S

ci. U

SA 9

4, 4

853-

4860

, 199

7

http

://w

ww.

phys

ics.n

yu.e

du/g

rierla

b/ho

t/hot

.htm

l

Kel

lerm

ayer

et a

l. Sc

ienc

e 27

6, 1

112,

199

7;

Rie

f et a

l. Sc

ienc

e 27

6, 1

109,

199

7 K

awag

ushi

et a

l., S

cien

ce 2

91, 6

67, 2

001

a.

lase

r-sol

dere

d tis

sue;

b.

sutu

red

tissu

e;

http

://oe

mag

azin

e.c

om/fr

omTh

eMa

gazi

ne/s

ep01

/wel

ding

.htm

l

•

•

Ligh

t ene

rgy

irrad

iate

d by

the

lase

r ra

diat

ion

prob

e tip

rem

ains

loca

lly

and

conv

erte

d in

to th

erm

al e

nerg

y, w

hich

blo

cks

neur

al tr

ansm

issi

on in

an

ext

rem

ely

shor

t tim

e.

•

The

use

of c

onve

ntio

nal

lase

r be

ams

in n

euro

surg

ery

has

som

e im

porta

nt li

mita

tions

. The

lase

r coa

gula

tes

tissu

e bu

t doe

s no

t abl

ate

it.

Due

to

the

diffu

sion

of

heat

int

o su

rroun

ding

hea

lthy

tissu

e se

vere

si

de-e

ffect

s w

ere

obse

rved

, an

d th

eref

ore

the

appl

icat

ion

area

s ar

e ve

ry r

estri

cted

. In

add

ition

, th

e co

agul

ated

tis

sue

rem

ains

in s

itu a

nd

can

caus

e da

nger

ous

necr

osis

. •

:

Lase

r Neu

rosu

rger

y

coag

ulat

ion

prod

uced

with

a

conv

entio

nal C

O2

lase

r ab

latio

n w

ith u

ltra

shor

t-pul

sed

ND

:YLF

lase

r

http://www.dkfz-heidelberg.de/medphys

•H

o-YA

G la

ser (

= 2

080

nm, 2

0-10

0 W

) •

Mic

ro-w

ave:

The

rmal

Dam

age

C

old

Laser’

•Ap

plic

atio

ns in

Arth

rosc

opic

Sur

gery

M

enis

cal

C

hond

ropl

asty

()

Exci

sion

of O

steo

phyt

es (

)

Late

ral R

etin

acul

ar R

elea

ses

Supr

apat

ella

Plic

a Ab

latio

n (

)

Syno

vect

omy

()

•

Adva

ntag

es

Elec

troca

uter

y

Vario

us c

apab

ility

: cut

ting,

coa

gula

tion,

vap

oriz

ing,

and

scu

lptin

g

No

side

-effe

ct (v

s. N

d-YA

G la

ser,

= 1

064

nm, u

p to

30

W m

aybe

hig

her)

Pow

erfu

l ene

rgy

(mor

e th

an 4

0 W

)

Lase

r in

Lith

otrip

sy

•H

igh

pow

er N

d-YA

G/H

O-Y

AG la

ser +

cy

stos

cope

or u

rete

rosc

ope

•

.

•

• X

-ray

Trad

ition

al

ultra

soun

d-ba

sed

sche

me

Lase

r Lith

otrip

sy

http

://w

ww.

urol

ogym

atch

.com

/Ure

tero

scop

y_ur

olog

ymat

ch.m

ov

http

://w

ww.

cook

grou

p.co

m/c

ook_

urol

ogic

al/p

rodu

cts/

uret

eros

copy

1 2

3 4

5

•LA

SIK –E

xcim

er la

ser (

193

nm)

•Sp

ot s

cann

ing

-

:

.

-

:

,

.

,

,

(

)

-

:

http

://w

ww

.ose

osye

.com

/ope

ratio

n/la

sik.

htm

Lasi

k: a

form

of r

efra

ctiv

e la

ser e

ye s

urge

ry p

roce

dure

per

form

ed b

y op

htha

lmol

ogis

ts

inte

nded

for c

orre

ctin

g m

yopi

a, h

yper

opia

, and

ast

igm

atis

m

Anes

thet

ic e

yedr

ops

+ su

ctio

n rin

g st

abiliz

es th

e ey

e po

sitio

n.

Mic

roke

rato

me,

mec

hani

cal s

have

r, cr

eate

s a

parti

al fl

ap in

the

corn

ea o

f uni

form

thic

knes

s.

Cor

neal

flap

is fo

lded

bac

k.

An e

xcim

er la

ser i

s th

en

used

to re

mov

e tis

sue

and

resh

ape

the

cent

er o

f the

co

rnea

.

The

front

sur

face

of t

he

eye

is n

ow fl

atte

r sin

ce th

e fla

p co

nfor

ms

to th

e un

derly

ing

surfa

ce.

http

://w

ww.

wik

iped

ia.o

rg

LASI

K Su

rger

y LA

SEK

and

PRK

Surg

ery

PRK:

Pho

tore

fract

ive

kera

tect

omy

Beca

use

PRK

does

not

invo

lve

a pe

rman

ent

flap

in t

he d

eepe

r co

rnea

l lay

ers

(the

LASI

K pr

oced

ure

invo

lves

a

mec

hani

cal

mic

roke

rato

me

usin

g a

met

al

blad

e or

a

fem

tose

cond

la

ser

mic

roke

rato

me

to c

reat

e a

'flap

' out

of t

he o

uter

cor

nea)

, the

cor

nea'

s st

ruct

ural

inte

grity

is le

ss

alte

red

by P

RK,

but

PR

K ca

n be

mor

e pa

infu

l and

vis

ual r

ecov

ery

is s

low

er. T

he u

se o

f the

ant

i-m

etab

olite

mito

myc

in c

an m

inim

ize

the

risk

of p

ost-o

pera

tive

haze

in p

erso

ns r

equi

ring

larg

er

PRK

corre

ctio

ns.

The

LASI

K pr

oces

s w

ill co

ver t

he la

ser t

reat

ed a

rea

with

a fl

ap o

f tis

sue

from

100

to 1

80 m

icro

ns th

ick.

Th

is fl

ap c

an m

ute

the

nuan

ces

of th

e la

ser a

blat

ion,

whe

reas

PR

K al

low

s th

e la

ser a

blat

ion

at

the

oute

r sur

face

of t

he c

orne

a.

LASE

K is

a p

roce

dure

tha

t pe

rman

ently

cha

nges

the

sha

pe o

f th

e co

rnea

usi

ng a

n ex

cim

er la

ser

to

abla

te a

sm

all a

mou

nt o

f tis

sue

from

the

fro

nt o

f th

e ey

e, ju

st u

nder

the

eye

's o

uter

laye

r or

ep

ithel

ium

. U

nlik

e LA

SIK,

in

whi

ch t

he e

pith

eliu

m i

s no

t re

mov

ed f

rom

the

cor

neal

fla

p, t

he

epith

eliu

m is

kep

t off

the

eye

durin

g th

e pr

oced

ure

and

repl

aced

afte

rwar

d to

act

as

a na

tura

l ba

ndag

e.

Beca

use

it do

es n

ot i

nvol

ve a

kni

fe/m

icro

kera

tom

e/or

cut

ting

lase

r as

use

d in

LAS

IK,

the

corn

ea's

st

abilit

y is

left

virtu

ally

una

ffect

ed, b

ut th

ere

is m

ore

pain

and

vis

ual r

ecov

ery

is s

low

er th

an w

ith

the

latte

r pr

oced

ure.

Lik

e PR

K, L

ASEK

doe

s no

t run

the

risk

of d

islo

cate

d co

rnea

l fla

ps w

hich

m

ay o

ccur

infre

quen

tly w

ith tr

aum

a ev

en y

ears

afte

r LAS

IK. ht

tp://

ww

w.w

ikip

edia

.org

•La

ser h

air r

emov

al, r

ejuv

enat

ion,

ski

n re

surfa

cing

etc

. •

CO

2 (10

,600

nm

) / E

r-YAG

lase

r (2,

940

nm) :

, ,

,

•

Q-S

Nd-

YAG

/ Q

-S R

uby

/ Q-S

Ale

xand

rite

lase

r

:

–

. ,

, ,

•

Dye

lase

r

: -

,

,

,

•Lo

ng-p

ulse

Rub

y / A

lexa

ndrit

e / D

iode

lase

r

:

– L

-P A

lexa

ndrit

e la

ser ~

(

) •

IPL

(Inte

nse

Puls

e Li

ght/L

aser

, hig

h-po

wer

NIR

bro

adba

nd, e

g. 5

30~1

200

nm) t

hera

py

: –

spe

ckle

dis

pellin

g,

, ,

, h

air r

emov

ing

,

Car

bon

Dio

xide

Las

er S

kin

Res

urfa

cing

Befo

re

Afte

r IP

L Tr

eatm

ent

•O

tola

ryng

olog

ists

use

las

er s

yste

ms

for

exci

sing

ski

n tu

mor

s,

canc

ers,

birt

hmar

ks a

nd o

ther

dis

orde

rs o

f th

e he

ad a

nd n

eck:

Pr

oble

ms

of t

he v

oice

box

, th

roat

, m

outh

, no

se a

nd e

ar m

ay b

e am

enab

le t

o di

ffere

nt la

ser

treat

men

ts.

Nod

ules

or

poly

ps o

n th

e la

rynx

and

blo

od v

esse

l def

ects

in th

e up

per

airw

ay a

re d

isor

ders

th

at c

ould

be

treat

ed w

ith a

las

er.

In a

noth

er i

nsta

nce,

las

er

surg

ery

mig

ht b

e pe

rform

ed to

rem

ove

the

stap

es fr

om th

e m

iddl

e ea

r for

trea

tmen

t of o

tosc

lero

sis.

•C

O2 /

dio

de la

ser:

,

-

:

•N

d-YA

G l

aser

:

,

,

,

,

,

,

-

: ,

.

.

.

Nov

16,

200

4 L

aser

ther

apy

cure

s bad

bre

ath

Isra

eli d

octo

rs u

se a

CO

2 las

er to

abl

ate

the

tons

ils o

f pat

ient

s su

ffer

ing

from

seve

re h

alito

sis.

L

aser

ther

apy

coul

d be

the

answ

er to

bad

bre

ath

acco

rdin

g to

Isra

eli r

esea

rch.

In a

rec

ent s

tudy

, a

team

of d

octo

rs u

sed

a C

O2 l

aser

to c

ure

51 o

ut o

f 53

patie

nts

suff

erin

g fr

om s

ever

e ha

litos

is.

(Oto

lary

ngol

ogy

- Hea

d an

d N

eck

Surg

ery

131

372)

Col

leag

ues f

rom

Sap

ir M

edic

al C

entr

e, C

haim

She

ba M

edic

al C

entr

e an

d Te

l Avi

v U

nive

rsity

co

nduc

ted

the

rese

arch

to in

vest

igat

e to

nsils

as a

sour

ce o

f hal

itosi

s and

ass

ess t

he p

oten

tial o

f las

er

abla

tion

as a

trea

tmen

t. T

he st

udy

cont

aine

d 30

men

and

23

wom

en a

ged

from

18

to 6

1 ye

ars,

all s

uffe

ring

with

hal

itosi

s or

igin

atin

g fr

om c

hron

ic fe

tid to

nsill

itis.

In th

e co

nditi

on, t

he su

rfac

e of

the

tons

il be

com

es in

fect

ed

with

gas

-pro

duci

ng b

acte

ria

that

can

hid

e in

ope

ning

s kno

wn

as c

rypt

s and

cau

se b

ad b

reat

h.

The

trea

tmen

t con

sist

ed o

f gui

ding

a C

O2 l

aser

bea

m w

ith a

pow

er o

f bet

wee

n 10

and

20

W o

ver

the

tons

ils. A

scan

ner

quic

kly

rota

tes t

he fo

cuse

d la

ser

beam

ove

r a

3 - 4

mm

cir

cle

to v

apor

ize

the

tons

ils

with

out c

ausi

ng th

erm

al d

amag

e to

surr

ound

ing

tissu

e.

The

adv

anta

ge o

f the

tech

niqu

e is

that

it c

an b

e pe

rfor

med

in a

n of

fice

sett

ing

with

the

patie

nt u

nder

lo

cal a

naes

thet

ic. O

f the

53

patie

nts i

n th

e st

udy,

47

imm

edia

tely

res

umed

reg

ular

wor

k an

d ro

utin

e ac

tiviti

es. A

ll pa

tient

s wer

e ba

ck a

t wor

k w

ithin

3 d

ays o

f rec

eivi

ng tr

eatm

ent,

whi

ch la

sted

no

mor

e th

an 2

0 m

inut

es.

28 p

atie

nts w

ere

cure

d in

one

sess

ion,

18

patie

nts

requ

ired

a se

cond

vis

it an

d 5

patie

nts r

etur

ned

for

a th

ird

trea

tmen

t. "T

he fi

ndin

gs sh

ow th

at th

e to

nsils

are

a so

urce

of h

alito

sis,

and

are

effe

ctiv

ely

trea

ted

by la

ser

vapo

riza

tion,

" sa

id th

e au

thor

s in

thei

r pa

per.

"All

our

patie

nts w

ere

cure

d fr

om th

eir

bad

brea

th, 5

1 by

cry

ptol

ysis

[the

lase

r th

erap

y] a

nd o

nly

2 pa

tient

s by

tons

illec

tom

y."

Aut

hor

Ja

mes

Tyr

rell

is r

epor

ter

on O

ptic

s.org

and

Opt

o &

Las

er E

urop

e m

agaz

ine.

•

, .

•

,

,

•

,

, ,

•

•

•

,

•

lase

r

•

•

Ar-io

n (

/)

•sh

ort p

ulse

Nd:

YAG

lase

r •

CO

2 las

er

•D

iode

lase

r

Lase

r rem

ovin

g gu

m ti

ssue

. Las

ers

can

rem

ove

tissu

e pa

inle

ssly

with

no

blee

ding

.

whi

te li

ght i

llum

inat

ion

blue

ligh

t illu

min

atio

n in

dica

ting

resi

dual

tum

or:

PDT

is a

dmin

iste

red

with

red

light

(at 6

52 n

m) b

y th

e se

cond

gen

erat

ion

phot

osen

sitis

er m

eta-

Tetra

hydr

oxyp

heny

lchl

orin

(m

THPC

). Th

e in

traop

erat

ive

fluor

esce

nce

is in

duce

d by

a b

lue

light

sou

rce

at 3

70-4

40 n

m (f

ilter

ed x

enon

lam

p) a

nd th

e flu

ores

cenc

e is

det

ecte

d by

a m

odifi

ed C

CD

cam

era.

Th

is d

iagn

ostic

and

ther

apeu

tic c

once

pt c

an b

e su

mm

ariz

ed in

„to

see

and

to treat“.

R

ef:

Zim

mer

man

n A.

, R

itsch

-Mar

te M

., Ko

stro

n H

., m

THPC

-med

iate

d Ph

otod

ynam

ic D

iagn

osis

of

Mal

igna

nt B

rain

Tu

mor

s, P

hoto

chem

and

Pho

tobi

ol 7

4, 6

11, 2

001

Barre

tt's

esop

hagu

s is

a p

reca

ncer

ous

cond

ition

that

dev

elop

s in

app

roxi

mat

ely

10%

of

patie

nts

who

hav

e ga

stro

esop

hage

al r

eflu

x di

seas

e (G

ERD

). In

Bar

rett'

s es

opha

gus,

the

norm

al c

ells

that

line

the

esop

hagu

s, c

alle

d sq

uam

ous

cells

, tur

n in

to a

type

of c

ell c

alle

d sp

ecia

lized

col

umna

r cel

ls o

r Bar

rett'

s es

opha

gus.

Tab

le 1

: C

omp

aris

on o

f Es

oph

agec

tom

y an

d P

hot

odyn

amic

Th

erap

y (P

DT

),

htt

p:/

/w

ww

.bar

rett

s-es

oph

agu

s.or

g

Par

amet

er

Esop

hag

ecto

my

Ph

otod

ynam

ic T

her

apy

Proc

edur

e Ty

pe

In-p

atie

nt S

urge

ry

Out

-pat

ient

end

osco

py

Hos

pita

l Len

gth

of S

tay

7-55

day

s (A

vera

ge 3

wee

ks)

(1)

Non

e

30-d

ay M

orta

lity

3.4-

17.3

% (

2)

Non

e

In-h

ospi

tal M

orta

lity

4.8-

19%

(3)

N

one

Com

plic

atio

ns

(29%

) to

incl

ude

(1):

Pu

lmon

ary

com

plic

atio

ns

Car

diac

com

plic

atio

ns

Abd

omin

al A

bsce

ss

Ana

stom

otic

lea

k Ana

stom

otic

str

ictu

re

Wou

nd I

nfec

tion

Esop

h. s

tric

ture

(20

%)

(4)

Phot

osen

sitivi

ty 4

-6 w

eeks

Atr

ial f

ibri

llation

(1%

) TE

fis

tula

(0.

3%)

Rec

over

y/Ret

urn

to w

ork

2-4

mon

ths

(4)

2-3

wee

ks (

4)

Cha

rges

$8

7,88

7-$1

18,5

00 (

3)

$30,

000-

$35,

000

(Avg

. $3

2,00

0) (

5)

1. K

arl e

t al.

Ann

als

of S

urge

ry v

ol. 2

31, n

o 5,

200

0.

2. B

egg,

et a

l. JA

MA

, vol

. 280

, no.

20,

199

8.

3. P

atti,

et a

l. Jo

urna

l of G

astro

inte

stin

al S

urge

ry, v

ol. 2

, no.

2, 1

998.

4.

Ove

rhol

t. A

mer

ican

Jou

rnal

of M

anag

ed C

are,

vol

. 6, n

o. 1

6, s

up, 2

000.

5.

Fac

ility

cha

rges

for I

njec

tion

of P

hoto

frin,

Pho

tody

nam

ic T

hera

py s

essi

on, a

nd 4

8-ho

ur fo

llow

-up

endo

scop

y (w

ith m

ore

PD

T if

need

ed).

(a)

Exte

nsiv

e ch

est w

all r

ecur

renc

e of

bre

ast c

ance

r. (b

) Th

is p

hoto

sho

ws

the

lesi

ons

one

mon

th a

fter

usin

g PD

T. (

c) T

aken

3 m

onth

s af

ter

usin

g PD

T.

(Pho

tos

cour

tesy

of

Ron

Alli

son,

Buf

falo

Gen

eral

H

ospi

tal,

Buf

falo

, NY

)