Summary and Excerpts from an article originally posted by Veterinary Practice News March 22, 2012

Original Article By Lou Anne Epperley, DVM

Summary by Chris Smith, LightScalpel/Aesculight Blog Editor

The original article by Dr. Epperly addressed the use of several different varieties of laser technology which are becoming more and more common in veterinary practices. At Aesculight, our research has shown the CO2 surgical laser to be the most effective option for veterinarians and their patients due to the speed and efficiency with which it can be used allowing for faster, cleaner surgeries with less bleeding and shorter recovery. These excerpts will focus on the parts of the article that reflect that.

“Laser surgery is noted for an ability to minimize hemorrhage and seal nerves and lymphatics through photothermal activity,” said Kenneth Bartels, DVM, director of the Surgical Laser Laboratory at OSU’s Center for Veterinary Health Sciences. “This implies there is decreased inflammation and less pain. The surgical laser is a tool that can be used to great advantage with the appropriate understanding and training.”

And the education is out there: Dr. Bartels said laser theory is now incorporated into Oklahoma State University‘s veterinary clinical curriculum, along with wet labs for student chapters of the American Animal Hospital Association and American Association of Feline Practitioners.

For small-animal surgery, carbon dioxide lasers are used in cat onychectomies, several phases of brachycephalic airway syndrome surgeries, spays and neuters, tumor removals and surface incisions.

The CO2 laser offers advantages to practitioner and patient.

“The laser will cauterize small blood vessels as it cuts, and therefore you will have minimal hemorrhage,” said Kathleen Ham, DVM, assistant professor of small-animal surgery at The Ohio State University College of Veterinary Medicine. “This also means that you don’t really need to use a tourniquet, which would, in turn, reduce any risk of neuropraxia as a result of improper or too-long use.”

Ham, a diplomate of the American College of Veterinary Surgeons (ACVS), noted that the laser method shortens surgery time, because reduced bleeding makes the incision line easier to see and to close.

Dr. Ham cited a study comparing the two methods which found “The CO2 laser group seemed more comfortable the first day post-operatively. This is because the laser will vaporize small nerve endings, which produces a seal over the nerve, resulting in decreased action potentials,” she said.

 

Then there are the bulldogs—gotta love ’em, and many people do. Laser surgery is used for such brachycephalic surgical applications as elongated soft palate, stenotic nares and excision of everted laryngeal saccules.

“The CO2 laser can also be used to ablate tissue, for instance with perianal fistulas or in some oral surgeries,” Ham said.

CO2 laser technology also comes into play for ear surgeries, including biopsies, pinnectomies, aural hematoma repair and ear canal resections.

Bartels, a fellow of the American Society of Laser Medicine and Surgery, explained that a CO2 laser’s energy is very highly absorbed in water, making it ideal for incisional applications.

Dr. Garcia-Lopez, also an ACVS diplomate, said laser technology  is used at Tufts to manage varicose veins and endometrial cysts in multiparous mares, and “a lot of us use the CO2 lasers for neurectomies  on the palmar digital nerves“ of the foot. “We find that use of the laser, rather than a scalpel, to cut the nerve allows the nerve endings to heal better, and there’s less chance of neuroma formation.”

The veterinarians interviewed for this story happen to practice in academic hospitals, but surgical lasers, especially CO2 lasers, have also been adopted in private practice.

  • “Laser surgery is noted for an ability to minimize hemorrhage and seal nerves and lymphatics through photothermal activity.”
  • “Using a surgical laser in a practice is an economic decision as well as a decision to take a step higher using available medical technology. It is well worth the time and financial commitment to attend continuing education venues offered at a number of national and regional veterinary meetings.”
  • “A CO2 laser’s energy is very highly absorbed in water, making it ideal for incisional applications.”

-Dr. Kenneth Bartels, DVM

Director of the Surgical Laser Laboratory at OSU’s Center for Veterinary Health Sciences

Bartels has published more than 75 articles, written seven book chapters, and a book involving surgery and the use of lasers in both animals and people.

“Using a surgical laser in a practice is an economic decision as well as a decision to take a step higher using available medical technology,” he said. “It is well worth the time and financial commitment to attend continuing education venues offered at a number of national and regional veterinary meetings.”

Dr. Epperley is an associate veterinarian for Southern Agriculture Inc. in Tulsa, Okla. Before earning her  DVM from Oklahoma State University in 1999, she worked as a journalist in Oklahoma City, covering business and political news.

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