Full Description
One of the first applications of lasers was for surgery on the retina of the eye. That, and the evident analogy to the old dreams of powerful heat rays, led many to predict that lasers would quickly be used for all kinds of cutting and welding, including surgical applications. It was soon apparent that laser sur gery could be performed in ways that caused little bleeding. Nevertheless, other surgical applications have been slower to arrive. One difficulty has been the enormous range of possibilities provided by the many different kinds of lasers. Infrared, visible, and ultraviolet light beams each interact very differently with human tissues. Light pulses of enor mously great peak powers became available from lasers, but their effects dif fered in surprising ways from those obtained with continuous beams. That provided both opportunities (i.e., treating or removing a very thin surface layer without affecting the underlying tissue) and problems with undesired side effects. Moreover, techniques were needed to deliver a precisely con trolled amount of energy just where it was desired. Lasers also had to be engineered and manufactured with the desired power levels and a high reliability.
Contents
1 An Introduction to Lasers.- 1.1 General Information.- 1.2 Theoretical Background.- 1.3 Historical Data.- 1.4 Basic Physics of Generating Laser Energy.- 1.5 The Molecular Gas Laser (Carbon Dioxide Laser): Energy Levels in Molecules.- 1.6 The Liquid Laser.- 1.7 The Solid-State Laser.- 1.8 The Semiconductor Laser.- 1.9 General Characteristics of Lasers in Medicine.- References.- 2 Carbon Dioxide Laser Instrumentation.- 2.1 General Description.- 2.2. Biophysical Data.- 2.3. Current C02 Laser Models.- 2.4. Laser Safety.- References.- 3 Bioeffects.- 3.1 Introduction.- 3.2. Plume Emission Analysis.- 3.3. Photoacoustic Properties.- 3.4. Photon-Tissue Interaction.- References.- 4 Applications in Gynecology with Emphasis on the Cervix.- 4.1. Introduction to Laser Surgery.- 4.2. Clinical Applications in Gynecology.- 4.3. General Considerations of Applications in Cervical Intraepithelial Neoplasia.- 4.4. Cervical Applications.- 4.5. Technical Approach to CIN Lesions.- 4.6. Vaporization Procedure.- 4.7. Excisional Conization.- 4.8. Postsurgical Care.- 4.9. Evaluation of Healing.- 4.10. Follow-up Examinations.- 4.11. Current Research on CIN.- 4.12. Complications.- 4.13. Laser Technique versus Conventional Methods.- 4.14. Other Indications for Laser Surgery.- References.- 5 Laser Surgery of the Vagina, Vulva, and Extragenital Areas.- 5.1. Introduction.- 5.2. Vaginal Applications.- 5.3. Vulvar Applications.- 5.4. Lower Genital Tract Multicentric Viral Lesions.- 5.5. Other Sites.- References.- 6 Intra-abdominal Applications.- 6.1. Introduction.- 6.2. Instrumentation.- 6.3. Microsurgical Procedures.- 6.4. Conclusion.- References.- Appendixes.- Appendix A. Zeiss Operating Microscope.- I. Optical Principles, Illumination Systems, and Support Systems.- II. Individual Parts, Handling, Assembling, Focusing, and Balancing.- III. Accessories.- IV. Documentation.- V. Maintenance and Cleaning.- Appendix B. Patient Information: Laser Surgery.- Appendix C. Discharge Instructions.- Appendix D. Informed Consent.- Appendix E. Laser Certification.- Appendix F. Societies.- Appendix G. Publications.- Appendix H. Glossary of Laser Terminology.
