One of Halsted’s principles of surgery is meticulous control of bleeding. Within referral practice I’ve seen surgery with very little bleeding, however today I saw surgery with no bleeding at all.
This is something that I’ve never seen before; it was done with a co2 laser which is a machine that I’ve read about yet and seen yet never used before. Laser surgery machines tend to be expensive to buy, a little scary to use, and (currently) are uncommon in general practice. However today I was in a referral hospital with some amazing high tech equipment including a CO2 laser.
Now the principle of lasers is using a specific wavelength of light to disrupt the water in the cell causing the cell to shrink and die. The light is highly focused on a specific area and will cut the tissue whilst at the same preventing bleeding.
Something that I’ve read before is that electrocautery should not be used on mucous tissue such as in the nose or soft palate as it does result is a lot of swelling. So I’ve only ever seen surgery here done with a scalpel which was very bloody and difficult because you simply could not see because of the blood.
Today with the laser the tissue just separated without blood allowing complete visualisation of the area of the surgery. It was easy to suture as we cut so that we could see how the tissue went together and what the outcome would be. This allowed the removal of more tissue than may otherwise have been taken for the fear of being able to reconstruct it adequately.
In addition to the lack of bleeding, the speed of the surgery was increased simply because of the greater ability to see the surgical area. I personally think that the use of such lasers are going increase and will eventually become common tools in every surgical referral center.