Use of sculpted contact fibers and the Nd:YAG laser in neurosurgical applications

We discuss our experience using Nd:YAG contact fibers (both conical and hemispherical versions) for neurosurgical procedures involving 22 patients. These fibers represent important tools in the neurosurgical armamentarium, especially in deep lesions and near-eloquent brain regions. Handheld contact fibers are excellent surgical tools for incision, excision, hemostasis, and vaporization of lesions. These 'sculpted' contact fibers offer advantages over the sapphire tips previously used for incision and excision. In addition to their larger size, the sapphire tips had to be frequently replace due to damage from overheating; this lengthened the time required to perform an operative procedure. the introduction of sculpted fibers represents an improvement in laser delivery systems for neurosurgical use.