OA Minimally Invasive Surgery

Review

Bone, Cartilage & Tendons

Canestri F. The laser beam deployment in minimally invasive surgery procedures for orthopaedic and generic low-water-content tissues treatments. OA Minimally Invasive Surgery 2014 Feb 22;2(1):2.

Abstract

The application of laser beams in the treatments of biomedical media has always been approached by both industrial and research laboratories since more than 35 years. Two major families of commercially available medical lasers differ themselves from the operative wavelength of the electromagnetic energy emitted by the cavity of the device. These are the following (Fig.2) : the beams showing “absorptionâ€�modalities by the tissue (CO2 lasers-like) in the region of 10 ï�­m wavelength and the other ones showing “scatteringâ€�characteristics into the tissue (YAG lasers-like) in the region of 1 ï�­m. The first one shows strong cutting and haemostatic characteristic especially in low-water content conditions, while the second one shows strong concentration (“pile-upâ€�) of energy below the surface with consequent heating (for pure thermodynamic applications), cutting and haemostasis of the irradiated volume in the depth of the same. One key aspect always to be considered is the combination of : the water / liquid content of the irradiated tissue, the biochemical / anatomical structure of the tissue, the beam wavelength and the emitted energy on the spot (power density - Joules / sec. cm2) located on the surface to be treated. Other 4 parameters play key roles in the quality of the outcome of the laser therapy : 1) the lateral “sizeâ€�of the beam (TEM Mode –Fig. 3) regulating ultimately the size of the focal spot where the laser beam energy is focused on the surface to be treated; 2) the total time duration of the exposure of the tissue to the beam itself; 3) the modality of the beam delivery, which can be either configured in continuous- or pulsed-mode and 4) the amount of the beam energy in Joules or Watt (Joules / sec.) delivered to tissue.

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