Laser surgery
Laser surgery utilises temperature of over 100°C
Destruction of tissue is achieved by:
1. Vapourisation
2. Haemostasis through heat coagulative necrosis
3. Fine incisions
Advantages
- Causes little bleeding, as haemostasis is obtained during vapourization
- Less painful post –op and swelling is less
- Little post-op scarring
- Particularly helpful for surgery close to important anatomical structures, such as for lesions affecting the floor of the mouth
Disadvantages
- Treatment is usually best under general anaesthesia
- Equipment is expensive
- Hazards to eyes in particular
- Laser travels in straight lines, making access to lesions a little difficult
- Laser can damage teeth
Potential hazards of laser therapy
1. Damage to the eyes and other tissues as a result of reflection of the laser beam from surgical retractors, mouth props or anaesthetic tube couplings
2. Vaporization of anaesthetics tubes, leading to ignition of flammable anaesthetic agents
Indication
Can be used for the treatment of leukoplakia, early neoplasia and haemangiomas. As in cryosurgery, histopathological diagnosis should be obtained pre-operatively.
Procedure
The carbon dioxide laser is a cutting laser and can be used to excise, or to fulgurate (electrodessicate) the lesion.