Lasers provide a means of delivering energy to precise sites inside the body under very exact control via rigid or flexible endoscopes. The effects produced are thermal and can be used to control haemorrhage or destroy neoplastic tissue. The carbon dioxide laser is the instrument of choice for treating early neoplasia of the cervix and has an established role in surgery of the upper respiratory tract, particulary the larynx, although its beam cannot yet be transmitted via flexible fibres.
It has provide effective in the non-surgical management of haemorrhage from peptic ulcers and is establishing an important role in the endoscopic treatment of a wide range of tumours. Excellent palliation is possible for advanced obstructing cancers of the upper and lower gastrointestinal tract and of the major airways in cases unsuitable for surgery, and good results are available for ablation of early tumours of the bladder. Lasers may also prove useful for recanalisation of occluded arteries. The potential for the endoscopic use of lasers is enormous, and this is just beginning to be realized.
What are the indications for Endoscopic Laser Surgery?
Early stages of larynx cancer, tonsil cancer, leukoplakia of the tunica mucosa of the mouth, precancerous vocal apparatus disorders and other early stage neoplastic processes of the head and neck.
What are the advantages of endoscopic laser surgery?
Endoscopic laser surgery allows patients with head and neck tumors to forego chemoradiation, which usually lasts for long periods of time and has a number of treatment-related complications.
No swelling after the surgery, which may make breathing and, in some diseases, eating more difficult.
Less trauma and quicker recovery after surgery.
Which laser is used in endoscopic application?
Interstitial laser photocoagulation
High power NdYAG laser is used during endoscopy, with short shots of a second or two, typically at 50-80 W. The laser fibre is held away from the surface of the target to vaporize and coagulate tumour tissue under direct vision.