What are lasers
Clinical laser history
Lasers and tissue interactions
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Lasers used in vascular treatments
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  Clinical laser history
The application of laser to surgical practice is a constantly evolving chapter in medical procedures. Laser is the short form of Light Amplification by The Stimulated Emission of Radiation. This concept is a part of quantum electronics popularly known as laser physics, which was established by Albert Einstein. Einstein worked upon Neil Bohr’s model of the atom and postulated the theory of the stimulated emission of radiation, which led to the development of the laser.

If we elaborate on the concept of the laser, it could be defined as electromagnetic radiation of any wavelength (light) made larger and more powerfully active (amplification and stimulation) and sent out (emission) as transmitted energy in the form of waves (radiation). The process can be explained as a condition when photons of light get excited, produce more photons and are released as laser energy in the form of a beam or ray.

However, it was much later in 1954 that the prospective of laser technology was identified. The process was triggered off by two scientists of Bell Laboratories, Arthur L Schawlow and Charles H Townes. They came up with groundbreaking ideas about laser activity, which they got published in a scientific journal in 1958 and simultaneously applied for a patent. Their work was acknowledged worldwide. Townes went on the get the Nobel Prize in Science in 1964, which he however shared with Alexander Prochorov, who had developed the same theory in Moscow.

There was a third researcher in the same field, who however failed to get befitting credit for his work. It was Gordon Gould, a researcher at Columbia University, New York. Though he developed upon the same concept that won acclaim for Schawlow and Townes, he could not publicize it in time and filed his patent nine months after the duo. Though he got credit for introducing the term “laser,” he had to fight a long battle before his work was acknowledged.

Laser technology next got an impetus in 1960, when physicist Theodore H. Maiman, invented the first working surgical laser. It was a flashlamp-driven ruby laser, producing millisecond pulses of 694 nm of red light. This marked the beginning of implementing laser technology for surgical purposes. Thereafter various new forms of lasers and their application followed. Here is an overview of the different types.

Ruby laser

After Maiman’s invention, scientists at Bell Laboratories introduced the ruby laser as a surgical device. The flash lamp was later substituted with an arc lamp. This ensured that the laser could be continuously functional. The first application of the ruby laser was in the rectification of retinal hemorrhages. This happened after ophthalmologists documented that the wavelength of the ruby laser could pass through the light tissue of the eye with negligible consequences. They also found that it was also effectively absorbed in the dark red tissue of the retina. However, later the argon laser was preferred over the ruby laser for retinal surgery.

Helium-Neon (HENE) laser

Ali Javan, a scientist at Bell Laboratories, is credited for the development of the helium-neon (HeNe) laser in 1960. With its discovery, laser wavelength could be delivered in a continuous mode. The HeNe gas laser revolutionized telecommunications. In 1960, right after the first functional HeNe laser went into action; Bell Laboratories’ scientists used laser technology to transmit a telephone conversation. Since then laser telecommunication through fiber optics has been indispensable to the cell phone, computer and television technology.

In the medical sector HeNe laser is used by surgeons to visualize invisible lasers such as carbon dioxide (CO2), holmium and yttrium aluminum garnet (YAG) wavelengths. The HeNe laser is also used in laser pointers and laser light shows.

Carbon dioxide (CO2) laser

This was the first invisible laser and was invented in 1964 by Kumar Patel, yet another Bell Laboratories’ scientist. This laser functioned in a CO2 medium. In 1972, the CO2 laser became applicable to laser surgery, when it was customized to work with the functional microscope. Since then CO2 laser has proved to have an edge over other laser wavelengths and soon became the mainstay of laser surgical procedures.

Neodymium YAG (ND:YAG), argon and potassium titanyl phosphate (KTP) laser

The year 1964 saw the development of two new lasers, the neodymium YAG (Nd:YAC) laser and the argon laser. In 1981 came the potassium titanyl phosphate (KTP) laser. Holomium, excimer and tunable dye wavelengths are the latest developments in laser technology.

Laser treatments

Laproscopic surgery or minimally invasive surgery with laser technology was the first major development in clinical laser treatment between 1989 and 1992. It was first implemented in biliary disease. However, it remains a cost prohibitive option and hence not the first choice in most surgical cases.

However, with all the many laser developments, laser surgery has become a reality in various medical fields. Regardless of the specific laser use in the clinic for different conditions, lasers operate with almost the same basic technology. Indeed, not much has changed in the basic design and laser technology with which they started off, with the additions of computerized and stable functions and more sophisticated surgical techniques.

Lasers became more easy to use after 1992, with state-of-the-art control mechanisms. All this and much more have been milestones in the advancement in medical technology and laser has become one of the most sophisticated choices in surgical techniques.


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