Laser Surgery

Overview

LASER is an acronym for:

L: Light
A: Amplification (by)
S: Stimulated
E: Emission (of)
R: Radiation

The world’s first laser was developed in 1960 by Theodore Maiman, with the term “laser” coined by Gordon Gould. A laser works by absorbing energy in one form and emitting it as a concentrated beam of light, making it a powerful and versatile tool across various applications.

The biophysics of laser-tissue interactions

Surgeons currently using lasers seek 4 different effects-

Thermal
Mechanical
Photochemical
Tissue welding effects

Advantages and Disadvantages

Advantages of Laser Technology

Greater precision and accuracy: Ensures targeted treatment with minimal damage to surrounding tissues.
Minimally invasive: Reduces trauma compared to traditional surgical methods.
Reduced pain: Procedures typically cause less discomfort for patients.
Minimal bleeding and swelling: Laser seals blood vessels during treatment, leading to faster recovery.
Ideal for high-risk patients: A safer option for individuals with multiple comorbidities who are unsuitable for open surgery.
Shorter procedure and hospital stay: Many treatments are quick and performed on an outpatient basis.

Disadvantages of Laser Technology

Requires skilled operators: Proper training and experience are essential for safe and effective use.
High cost: Laser equipment is expensive and not universally accessible.
Safety precautions: Stringent safety measures must be observed in the operating room to avoid risks.

Common Types of Lasers in Urology

KTP (Potassium Titanyl Phosphate)
LBO (Lithium Triborate)
Diode Laser
Nd:YAG (Neodymium-doped Yttrium Aluminum Garnet)
Ho:YAG (Holmium:YAG)
Thu:YAG (Thulium:YAG)
CO₂ (Carbon Dioxide)

Current Applications of Lasers in Urology

Laser Prostatectomy for BPH: Effective in managing benign prostatic hyperplasia.
Laser Lithotripsy: Used to treat kidney, ureter, and bladder stones.
Laser Bladder Neck Incision (BNI): Provides relief for bladder outlet obstruction.
Laser Endopyelotomy: Treats ureteropelvic junction obstruction.
Laser Optical Internal Urethrotomy (OIU): Repairs urethral strictures.
Laser Infundibulotomy: Addresses kidney infundibular stenosis.
En Bloc Resection of Bladder Tumors: Ensures precise removal of bladder tumors with minimal recurrence.