Laser Surgery
Laser surgery in urology
Laser
is an acronym for Light Amplification by the Stimulated Emission of
Radiation. Albert Einstein proposed the concept of stimulated emission
of radiation but it was not until 1960 that T.H. Maimen produced the
first visible light laser.
Recent advances in lasers and
fiberoptics make them ideally suited to travel through the smallest tube
or cavity in the human body. With widespread use of small-caliber
endoscopic instruments, urology has been drastically and positively
influenced by this technology, perhaps more so than any other surgical
discipline..
How does laser work in surgery ?
The mechanical effect results, for example, when a very high power laser is directed at a urine stone and a column of electrons is freed rapidly at the stone surface. This creates a plasma bubble that swiftly expands and acts like a sonic boom to disrupt and break the stone.
Laser prostate surgery |
Laser prostate surgeryuses the thermal effect to vaporize enlarged prostate
tissue. We perform Photoselective Vaporization
ofProstate using a green
light laser. This laser, also known as a potassium-titanyl phosphate
(KTP) laser, yields a green visible
light beam of 532 nm.
It is a form of minimally invasive endoscopy therapy
.
It uses a unique high power laser energy, which is
selectively absorbed by
blood (hemoglobin) within the prostate tissue. The laser energy is
transformed in to thermal energy, leading
to vaporization and
removal of the tissue. This results in an open the channel for passage
of urine from the bladder.
As
the laser energy is
selectively absorbed by blood, the laser seals blood vessels beneath the
area of vaporization, which results in
substantially less
bleeding, compared to traditional transurethral resection of prostate
(TURP) surgery. There are much fewer side
effects and recovery is
much quicker.
Laser stone surgery
Laser stone surgeryuses
the mechanical effect to break all types of stones in the kidney or
ureter. It uses a Holmium:YAG (Ho:YAG)
that emits a beam of
2150 nm. The laser energy is delivered by a silica fiber in a pulsed
manner. Using a thermo mechanical action,
it superheats water,
which heavily absorbs light energy at this wavelength. This creates a
vaporization plasma bubble at the tip of
the fiber that expands
rapidly and shatters the stone in contact.
The absorption depth in
tissue is only 1-2 mm, minimizing damage
to the surrounding
structures. The laser fiber is introduced via a fine surgical
instrument called an ureteroscope, which is
placed into the urine
passage tube. The ureter stone is identified and broken down by laser by
direct contact. Fragmentation with
laser is very precise.