Dog meet co2 laser…

Veterinary CO2 Laser

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.

An introduction to lasers in the veterinary world

Vet Laser Surgery

Technology is becoming more and more important in our ability to treat animals with more care and advanced techniques. Something that has been accepted rather quickly is the use of lasers however there are several different types available.

Lasers basically work on simple physic principles and emit a beam of light of different wave lengths (such as visible or infrared or colored light) and powers which are set to interact with different types of tissues. By adjusting the wavelength you can affect different types of tissue so can target skin, muscles, bone or blood vessels.

There are two ways to categorise lasers by their purpose – you can either get therapeutic lasers or alternatively the surgical lasers. With the therapeutic laser these are most often known as Low Level Laser Therapy and are generally class 4 laser products. These are often used in rehabilitation to improve wound healing or reduce pain both of which are shown to have a greater outcome.

Therapeutic lasers come with different power abilities which affect how deep the laser will go within the body. Also something that can be changed is the pattern of the wave of the light in different pulses to stimulate the cells in different ways. Often a course of treatment is used over a period of time to help with healing and pain with some significant reduction in rehabilitation time after things like spinal surgery.

Surgical lasers are generally a lot stronger and are used by surgeons instead of scalpels to cut tissue both in open surgery and through minimally invasive surgery with an endoscope. These generally act on the water inside the cells. There are 3 different types of surgical lasers which are:

CO2 (Carbon Dioxide) laser – this allows a surgeon to cut or vaporise tissues whilst minimising the bleeding that occurs. This happens because as the water in cells of the blood vessel walls is removed from the cell it shrinks and so the size of the vessel decreases to stop blood passing through it.

Nd:YAG (Neodymium:yttrium-aluminum-garnet) lasers are extremely powerful that have very deep penetration which allows surgeons to target parts of the body not so accessible. These are often used in endoscopic surgery and are commonly used in human on tumours of the stomach and digestive system.

Argon laser – this laser has relatively limited penetration of around 1mm and is often used for eye surgery or for superficial skin disorders. These lasers have a special use where light sensitive dyes can be injected into a tumour and the laser specifically targets the cells containing these dyes to remove specific tumour cells.

The ability to use lasers within veterinary surgery now gives us many new possibilities for attempting to reduce the risk in what are classed as risky surgeries now. It has always been known that control of bleeding is essential to surgery and reducing this does show potential for better outcomes.

However the downside of surgical lasers at least is that when working with tumours they can be turned to particles in the air that can be breathed in by the surgical team so good personal protection and removal of the “smoke” from the laser is essential.