Study on Indication of the Carbon Dioxide baser in General Surgery

Abstract

The carbon dioxide laser (Medilaser-S having 60w. max. power) was first installed at Jikei Hospital in 1977. Since the time it was used on various operation in general surgery and we have experienced over two hundred cases.
This study presents the results of laser indication in general surgery by examination of our clinical cases.
1. Surgery for body surface
Most of the tumors of the body surface were good indication for laser surgery. Laser irradiation therapy was also effective for debridement of wet wound with infection. 20-25w. focused or defocused laser beam was usually used for vaporization or laser cutting extirpation and the results were all satisfactory.
2. Surgery for ano-rectal diseases
Fistula-in-ano was the best indication among the ano-rectal diseases. Radical operation for fistula-in-ano was performed by means of irradiation of 20-25w. focused or defocused laser beam, and pathological tissue of the fistula was completely vaporized without bleeding. Postoperative course was quite smooth under painless condition and the wound healing was satisfactory without keloid formation.
3. Surgery for hepatectomy
To the parenchymal organ with a lot of blood supply, laser cutting method is very useful because of its haemo-static effect.
S cases of hepatectomy were performed by means of laser cutting method, 60w. defocused beam from 2.0mm to 1.0mm in spot diameter was most suitable for laser cutting, and we acknowledged that the most effective procedure was to control blood supply at the root before laser resection and to ligate the blood vessel over 1mm in diameter. The result was that bleeding volume during operation decreased significantly and the liver surface cut with laser was kept dry without oozing of blood as well as bile juice.