Lasers and the surgeon.

The evolution of laser technology in medicine has progressed rapidly over the past 25 years, and these devices are widely used in surgical treatment today. Three different types of lasers are predominantly used: the carbon dioxide, argon ion, and neodymium-YAG instruments. Each operates on similar principles but because of the different wavelengths of light emitted, their applications differ. However, by and large, all of them utilize thermal energy generated by light and tissue interactions. Recently, the combination of an argon ion and a dye laser used with photosensitizing drugs has shown promise in the treatment of cancers, and this represents a nonthermal application of laser technology. In order to use lasers effectively, a knowledge of the specific laser and tissue properties is essential. In the future, lasers will be used not only as thermal scalpels but also as instruments than can provide a very precise delivery of energy to parts of the body that are otherwise inaccessible without operation. The use of photodynamic therapy will provide a mechanism of selectively destroying tumors while leaving normal tissues intact.

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