New trends in application of laser in general surgery

Abstract

Lasers have many applications in general surgery. In hepatobiliary surgery, laser are used for percutaneous lithotripsy using the holmium:YAG laser for patients with primary hepatolithiasis, laser laparoscopic cholecystectomy, and interstitial ablation for hepatic tumours including hepatocellular carcinoma, and colorectal liver metastases. Photodynamic therapy is used for hilar cholangiocarcinoma where a photosensitizing drug known to preferentially accumulate in tumor cells is administered, and the tumor is exposed to nonthermal laser light of the appropriate photoactivating wavelength after a time interval required for the drug to accumulate in tumor tissue. In anorectal surgery, the hemorrhoidal laser procedure ‘‘HeLP’’ technique is a new surgical procedure where the closure of terminal branches of the superior rectal artery is achieved by means of a laser beam. In anal fistula, complete excision of the fistula track with subsequent repair of the sphincter muscle was performed where laser use results in minimal trauma to the sphincter muscle resulting in minimal trauma to the sphincter muscle with a reduced risk of developing troublesome fecal incontinence. Keywords: New Trends, General Surgery and Laser.