Lasers have revolutionized many surgeries

Since their invention 50 years ago, lasers have revolutionized eye, skin and vascular surgeries and aided treatment of certain cancers and other conditions.

Lasers are artificially created beams of light energy used in industry and medicine. The word "laser" is actually an acronym, meaning "light amplification by stimulated emission of radiation."

Surgeons use lasers to cut and vaporize tissue and seal blood vessels, according to the American Society for Laser Medicine and Surgery, based in Wausau, Wis.

"Lasers have become an extremely important tool for a variety of surgical procedures," noted Dr. Hormoz Mansouri, medical director of the Long Island Laser Center for Vein Treatment in Syosset.

USES

Mansouri's field of vascular surgery has reaped the benefits of laser surgery. Before the use of lasers, treating people with excruciating pain from varicose veins required extensive surgery under general anesthesia to tie off and remove swollen, twisted veins. The procedure posed a risk for scarring, and recovery was prolonged.

Today, treating varicose veins is a relatively quick and pain-free process. Through a tiny incision, the surgeon heats the vein, closing it off and shrinking it from within. The procedure is performed on an outpatient basis under local anesthesia.

"People who have been living with these painful veins for years walk into my office and, two hours later, walk out without it," Mansouri said. "It's really an amazing improvement. Now it's a relatively simple office procedure."

Lasers are also used, for example:

* To vaporize and remove tonsil tissue.

* To reshape the uvula and palate to reduce snoring.

* To treat some early-stage cancers of the larynx.

* To remove precancerous skin lesions, warts, age spots and tattoos.

* To remove cancerous tissue at the very early stages of penile, vaginal and non-small-cell lung cancers.

* To reduce vision loss from diabetic retinopathy.

* To treat certain types of age-related macular degeneration.

TYPES

Lasers are named for the substance used to create the light they emit, according to the U.S. National Cancer Institute. Common types of lasers used in surgery include carbon dioxide, argon and yttrium-aluminum garnet, and each is used for a different purpose. A newer laser system that uses green light is being marketed for treating an enlarged prostate.

BENEFITS AND RISKS

Lasers can exact more precise cuts than scalpels, resulting in less pain, bleeding, swelling and scarring, according to the cancer institute. And because recovery is quicker, people are less prone to infection.

On the other hand, laser therapy requires specialized training and safety precautions. In the wrong hands, lasers can damage skin, for example.

"There are so many different types of laser machines, and unfortunately the public is not served properly by people who abuse the use of lasers," Mansouri said.

And in many cases, especially surgeries involving deep tissue, lasers are not considered the best tool for the job.

"In what I do, they've really not had a role at all," said Dr. Gary Gecelter, chairman of the surgery department at St. Francis Hospital, whose office is in Manhasset and who specializes in surgical oncology.

Gecelter said he doesn't use laser techniques, preferring the harmonic scalpel, for example, which uses ultrasound to cut and coagulate tissue.

THE LONG ISLAND SCENE

People interested in whether laser surgery might be appropriate for them should talk to their surgeon about the various treatment options. In some cases, laser surgery could be either a good or not-so-good choice; in other types of surgery, it may not be an option.

People often confuse "laser" with "minimally invasive" or "keyhole" surgery, Gecelter added. The laser is a tool, not a procedure, and a surgeon might or might not use it during a minimally invasive surgery, which is a technique involving small incisions.