LASER SURGERY      by FRED CREUTZMANN, M.D. – 972-394-7277

The word LASER comes from, Light Amplification by Stimulated Emission of Radiation. What is a laser beam? It is to light what perfect pitch is to sound. The way this light is created is by heating the atomic structure of certain elements. These atoms, when heated, always respond by producing a given frequency or "tone" of light. If you imagine a trillion atoms in the beam producer, all being heated, and a trillion beams of light all in perfect harmony being produced, you have a laser beam. The different types of lasers are based on the material that is heated, CO„ Argon, Copper, etc. These different types of lasers produce beams that have different properties. Some can travel through water others can not and some work best on certain colored targets and some offer more power.

Why are lasers such a hot item? As a child, did you ever burn leaves by focusing the sun on them through a magnifying glass? The laser is similar to this, but with the laser, we can control the spot size, intensity and depth of tissue penetration with the turn of a dial. Lasers are now used in virtually all operative specialties to cut or vaporize tissue.

Gynecologists use primarily the CO, laser. For us the three main uses of laser are: in the treatment of genital warts, the removal of pre-cancerous cervical abnormalities and inside the abdomen through the laparoscope. Using this intense beam of light warts can be vaporized away. The laser can greatly limit the amount of injury to the surrounding tissues by using different power settings. Our limitation here is we can treat only what we can see, and the virus that causes this problem can be present in cells that appear normal at the time of surgery. This can lead to recurrences and additional treatment.

Cervical abnormalities found with pap smears and confirmed with colposcope can either be cut away or vaporized with the laser. There is still debate as to whether laser is more effective in this area than some of the less expensive treatments that are also available, such as freezing or cutting away the abnormal area with an old fashioned scalpel.

The other use of the laser is my favorite and it has some clear cut advantages. A beam can be guided into the abdomen through a tube-like device called a laparoscope. One can examine inside the abdomen and then using the laser, scar tissue or endometriosis can be removed in people in whom it is causing pelvic pain or infertility. Some ovarian cysts can also be removed through the "scope", although this is a newer area of use, in selected patients it can avoid major surgery. This decreases cost and recovery time remarkably. I have removed tubal pregnancies with the laparoscope and sent the patient home in less than 24 hours. This form of surgery can be quite difficult and time consuming, but success is very rewarding. Unfortunately, what needs to be done can not always be accomplished in this way and open surgery is sometimes required.