Procedures using intense beams of light to cut, join, or destroy tissue
Light from a laser can cut or destroy tissue or repair damaged tissue by fusing together torn edges. This ability allows lasers to be used in a number of surgical procedures in place of scalpels, scissors, and stitches.
A wide range of lasers is used for various purposes, including treatment of skin problems, operations on the eye, and internal operations that are carried out in conjunction with endoscopes (see Endoscopic surgery).
Since laser beams can be focused precisely, small sections of tissue can be treated without causing damage to the surrounding tissues. Lasers produce differing wavelengths of light that are absorbed by different types of tissue. For example, a wavelength of light that is absorbed by melanin (the dark pigment that gives skin its colour) may be effective in removing a mole caused by the over-production of melanin. A wavelength that is absorbed by blood causes clotting to occur and prevents bleeding from tissues cut during treatment.
Lasers generate intense heat, and laser treatment is therefore given in short bursts to avoid burning.
When is it used?
Laser treatment is used in gynaecological procedures. A laser beam can be directed into the body through an endoscope to remove scar tissue inside the fallopian tubes, which may cause infertility. Lasers are also used to remove cysts that form in the pelvic area due to endometriosis and to destroy abnormal cells on the cervix that, if left untreated, may develop into cancer (see Cervical intraepithelial neoplasia).
Small tumours or precancerous cells in other internal body areas, such as the larynx or inside the digestive tract, can be destroyed by laser beams directed through an endoscope. The technique can also be used to open arteries that have become narrowed by fatty deposits (see Atherosclerosis). In ophthalmic surgery, laser beams can be used to seal small tears in the retina, the light-sensitive layer at the back of the eye (see Retinal detachment).
Laser treatment is often used on the skin, especially on the face, for reducing scar tissue and birthmarks, noncancerous moles, wrinkles, or tattoos (see Laser treatment on the skin). The results depend on the extent of the problem but in most cases scarring is minimal, and the appearance of the skin is much improved.
What happens during the treatment?
Most forms of laser treatment are performed under either local or general anaesthesia, depending on the type of surgery and the area to be treated. However, for minor skin conditions, laser treatment causes little discomfort and may be performed without anaesthesia. There may be some swelling, redness, and blistering, which usually disappear within a week. Large areas of skin may need to be treated over several sessions.
What are the risks?
Occasionally, laser treatment may cause scarring, or there may be incomplete removal of damaged tissue. Skin treated by laser may also be vulnerable to infection until it has healed completely. The intense heat of the laser can sometimes lead to coarsening of the skin.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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