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The role of lasers in medicine (part 2)

Publisher/Author : Pacific Cross

The role of lasers in medicine

Authors:
1. Le Van Nhan MD., PhD., Director of Medical Services Department, Pacific Cross Vietnam, Lecturer of Pham Ngoc Thach University of Medicine
2. Tran Vinh Tai MD., MHEM, Lecturer of Pham Ngoc Thach University of Medicine

Laser in the treatment of diseases by traditional medicine

Laser acupuncture low-power semiconductor therapy (optical acupuncture) is one of the important applications of traditional medicine lasers, specializing in the treatment of common diseases such as: degeneration of the spine, lumbar pain, sciatic severe back pain… The principle of this method is based on Laser beam drilling capability. The Laser beams are directed deep into the acupuncture points, the interaction of photons in the beam with the acupuncture tissue, causing stimulation, acting as muscle stimulation. The use of an acupuncture Laser has the advantage of being able to do without needles and to be precise at acupuncture points. The Laser source for acupuncture is usually low power, rarely absorbed by water and does not cause infection.

Laser in surgery

People use the laser in surgery as a kind of scalpel because of the thermal radiation of the laser beam, which causes the evaporation of organizations in cuts; these cuts are very small, have less bleeding and less damage to surrounding healthy organizations.

We can say that the laser is the most delicate, safest and most sterile scalpel (with a temperature of 1.200 to 1.700oC, no bacteria can exist), the most versatile because it can interfere with difficult surgeries and difficult (deep, small cavities, hemophilia, vital organs such as the brain, spinal cord, etc.) that conventional surgical blades can not interfere.

Laser scalpel reduces or does not require local anesthetic; no contact between the device and the incision (absolute sterility); good hemostasis with microvascular; reduce edema, hyperaemia and loss; incision less injured.

When a Laser scalpel is used, the organizations coagulate under the effect of heat, which has the effect of causing haemostasis, detachment of the retina and, in particular, during a laparoscopic procedure, users are serve to diagnose and treat.

With the impact of the Laser on the biological organization, the radiation of the Laser is absorbed by the organic molecules, the circuits will fracture to create “micro explosions”, from which water will be expelled from the organization, Finally, organic organizations like peeled layers. The excimer Laser is used in medicine as a “cold cut” (non-thermal).

Laser applications in ophthalmology

A common application of ophthalmic Lasers is refractive corneal surgery. For myopic eyes, hyperopia or astigmatism, there is an imbalance between the focal points of optic organisms (the corneal, the lens) and the length of the eyeball. This is usually corrected by wearing a focused or diverging lens in the form of near, long distance or contact lenses. Another way to solve the problem is to be able to modify the radius of curvature of the corneal surface with an excimer laser

Laser applications in cosmetology

In cosmetic surgery, for each type of injury and surgery, people choose different types of Laser to meet the goal of selective destruction of tissue (depending on the selective absorption capacity of the pathological tissue at each length of wave). In cosmetology, we use lasers in two directions: cosmetic surgery and aesthetic care (cosmetic surgery); commonly used and highly effective such as LASER CO2, ND-YAG, Erbium, Q-Nd, Fraxel, V-beam, Ruby, Laser-CO2-erbium / YAG combination…

The Laser has maximum effect on congenital or acquired pigmented lesions such as dark blue, freckles, jaundice, congenital vascular skin lesions such as haemangiomas, redness and other lesions…

In plastic surgery, professionals often use thermal lasers as a scalpel, the most common being CO2 lasers, argon lasers and YAG lasers for treatment: acne scars, hemangiomas, melanoma, keloid scars, hypertrophic scars, postoperative hyperpigmentation marks, burns, eradication of bad moles, prickly warts, freckles, melasma, congenital reduction, facial skins at various speeds, hair removal.

In contrast, the Lasers used in cosmetic care are mainly cold Lasers, low power for pure skin care with techniques: exfoliate the skin, screening to stimulate the growth and renewal of skin cells, stimulates increased subcutaneous circulation to increase skin nourishment and reddish skin, stimulates proliferation, regenerates collagen and stroma to make the skin full and soft, increases the elasticity of the skin to eliminate wrinkles, anti-aging of the skin, preserving a youthful appearance for the skin, melt fat in areas of unwanted fat, firm up hanging pieces, restore and maintain the young physique of the body.

Laser applications in the treatment of cancer

The Laser is also used in the treatment of cancer because of many benefits: quite selective and specialized for all types of cancer; effective for all types of tumors; success rate of up to 90% for early-stage cancer (cancer of the esophagus and lung, because the cancer has increased, the success rate is higher than 70%); non-toxic, non-immunosuppressive and bone marrow inhibitor; no effect on other therapies (chemotherapy / radiotherapy) and has additional effects; the duration of treatment is short, effective and effective within 48-72 hours.

Lasers used in the treatment of cancer have three main applications: cancer surgery, cancer thermotherapy and photodynamic therapy. In recent years, people have been studying ways to use lasers to improve the functioning of the immune system.

Types of lasers used in cancer treatment: Laser CO2 – can remove a thin layer of tissue from the surface of the skin to the deeper layers, used to treat skin cancer and precancerous cells; Laser Nd:YAG (Neodymium:Yttrium-Aluminum-Garnet) – can penetrate deeply into the tissues and cause rapid blood clotting (scarring), can use optical fibers to conduct laser beams to treat hard-to-reach areas (treatment of throat cancer); Laser Argon – only transmitted by the superficial layers of skin such as skin, photodynamic therapy (PDT) using laser argon shines to activate photosensitive chemicals in cancer cells. Techniques are often applied: cut laryngeal cancer, lower throat with Laser, cut throat – larynx with Laser, cut laryngeal papilloma with Laser, cut tumors in the mouth and throat with Laser …

Laser applications in physiotherapy and rehabilitation

Numerous research projects as well as practical clinical applications show biological stimulating effects during laser projection. There are many applications that offer high efficiency in the prevention and treatment of diseases and the maintenance of human health, such as: screening for wound treatment (antiseptic wound, destruction of dead cells, strengthen anti-inflammatory, pain relief, healthy tissue proliferation, stimulate the granular organization of fast-growing wounds, accelerate healing and rehabilitation), screening stimulates a healthy organization to recover and promote health, maintain and improve normal physiological activity of body organs, correct disorders and improve the activity of the cardiovascular system, maintain the normal function of mental activity, increase blood flow in projected areas. Techniques are often applied in physiotherapy and rehabilitation such as: low power Laser treatment, with Laser He-Ne, with Laser YAC

Intravenous laser

Intravenous Laser is the introduction of a Laser head into the veins, using a low power Laser source for treatment or using a high power Laser source to cause venous congestion.

Laser applications in a number of in-depth specialties

  • In Emergency resuscitation and poison control: electrocoagulation treatment of bronchial endothelial tumors with laser
  • In Internal medicine: Bronchoscopy – treatment of tumors, scars of bronchial stenosis with Laser; treatment of prostate enlargement by lateral Laser; endoscopic procedure – gastrointestinal bleeding with argon Laser…
  • In Destistry: Laser root canal treatment uses the laser and seals the canal system with molten Gutta percha; restorative dentine treatment by GlassIonomer Cement (GIC) using the Laser; gum treatment with Laser…
  • In Dermatology: Rejuvenation of the skin by techniques Laser Fractional; treat ulcer pots in leprosy patients with Laser Hé-Né; melasma treatment with Laser Fractional; treatment of pigmentation, hyperpigmentation, genital warts, hyperkeratosis, molluscum contagiosum, papules… with Laser.
  • In Anaesthesia and Intensive Care: Anesthesia/resuscitation of retrograde ureteroscopy with flexible lithotripsy tube with Laser; anesthesia/resuscitation of infrared Laser surgery; anesthesia/resuscitation of surgical treatment of certain retinopathies with Laser (diabetic retinopathy, hypertension, premature babies…).
  • In Surgery: Percutaneous kidney stones with C. Arm + echography/ Laser.
  • In the field of burns: Diagnosis of burn depth with Doppler Laser, treatment of slowly healing wounds with Hé-Né Laser.
  • In Obstetrics and Gynecology: Treatment of cervical lesions by Laser engraving.
  • In Neonatology: Laser for the treatment of neonatal retinopathy.
  • In Otolaryngology: Surgery of Laser cut polyps, Laser surgery treats purulent Amygdala cavities…
  • In Micro surgery: Microsurgical surgery uses a laser to cut the vocal cords and cartilage on one side.
  • Lasers have many effective medical applications, but their use requires full understanding and strict adherence to the safety regime for physicians and patients./.

References:

  • Circular 50/2014/TT-BYT stipulating the classification of surgery, procedures and human standards for each surgery and procedure published by the Ministry of Health on December 26, 2014.
  • Biomedical Physics Program – Department of Biomedical Physics, Pham Ngoc Thach University of Medicine.
  • Conference “Laser and Applications in Medicine” – Department of Biophysics, Thai Nguyen University of Medicine.
  • Article “Laser applications in physiotherapy” of Huynh Van Loc, MD., Department of Physiotherapy – Rehabilitation, Hospital Central Highlands.
  • Ariticle “Laser therapy” of Ha Hoang Kiem, Associate Professor, PhD., Hospital 103.
  • https://www.researchgate.net/publication/231009441_Lasers_in_medicine.
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