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Encyclopedia of Health and Medicine

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266 Surgery<br />

TYPES OF SURGICAL LASERS<br />

Laser Type Characteristics Surgical Application<br />

argon gas shallow penetration dermatologic procedures<br />

moderately hot<br />

refractive surgery (vision correction)<br />

only pigmented tissues <strong>and</strong> fluids absorb the coagulate bleeding BLOOD vessels<br />

lightwaves<br />

carbon dioxide (CO 2 ) shallow penetration instead <strong>of</strong> scalpel for incisions<br />

very hot<br />

vaporize tissue (including tumors)<br />

only pigmented fluids absorb the lightwaves dermatologic procedures such as SKIN<br />

resurfacing<br />

neodymium:yttriumaluminum<br />

garnet (Nd:YAG) deep penetration fiberoptic transfer to locations within the body<br />

moderately hot<br />

vaporize or shrink tumors<br />

all fluids in the body absorb the lightwaves remove pigmented lesions<br />

remove tattoos<br />

pulsed dye shallow penetration port wine stain <strong>and</strong> other vascular birthmarks<br />

moderately hot<br />

tunable wavelength<br />

<strong>of</strong> choice for BLOODLESS SURGERY as well as for treating<br />

vascular disorders <strong>of</strong> the skin such as birthmarks.<br />

Because the intense light the laser generates<br />

can burn the RETINA <strong>and</strong> cause<br />

permanent blindness, people undergoing<br />

laser surgery as well as the surgeon<br />

<strong>and</strong> other members <strong>of</strong> the surgical team<br />

must wear EYE protection when the<br />

laser is in use.<br />

Laser surgery has the same risks as conventional<br />

surgery for bleeding <strong>and</strong> infection, <strong>and</strong> carries<br />

additional risk for BURNS <strong>and</strong> related damage.<br />

A laser can permanently discolor the skin, particularly<br />

the skin <strong>of</strong> people <strong>of</strong> color (notably African<br />

Americans, Asian Americans, <strong>and</strong> Hispanic Americans).<br />

Lasers may also cause burns <strong>of</strong> the skin.<br />

Though laser surgery makes many operations easier<br />

<strong>and</strong> more comfortable, it is important to<br />

choose a surgeon who is qualified to perform laser<br />

surgery <strong>and</strong> to fully underst<strong>and</strong> the potential benefits<br />

<strong>and</strong> risks <strong>of</strong> laser surgery compared to conventional<br />

surgery.<br />

See also LASER SKIN RESURFACING; MINIMALLY INVA-<br />

SIVE SURGERY; OPEN SURGERY; PHOTOTHERAPEUTIC KERA-<br />

TECTOMY (PTK); REFRACTIVE SURGERY; SURGERY BENEFIT<br />

AND RISK ASSESSMENT; TATTOOS.<br />

minimally invasive surgery Any OPERATION in<br />

which the surgeon uses an endoscope <strong>and</strong> specialized<br />

instruments to enter the body through small<br />

incisions, called ports. An endoscope is a lighted,<br />

flexible tube with a tiny camera at the tip that<br />

sends visual images <strong>of</strong> the operative site to a monitor<br />

similar to a television screen. The endoscope is<br />

specialized for the procedure, such as a laparoscope<br />

for operations within the abdominal cavity.<br />

The surgeon watches the images on the screen<br />

rather than seeing the operative site directly. Minimally<br />

invasive surgery is in contrast to OPEN SUR-<br />

GERY, in which the surgeon makes an incision<br />

large enough to allow direct access to the operative<br />

site. Surgeons must receive specific training in<br />

the minimally invasive procedures they perform,<br />

which require special equipment <strong>and</strong> instruments.<br />

Surgeons sometimes combine minimally invasive<br />

procedures with LASER SURGERY, assisted open surgery,<br />

or other operative techniques.

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