The carbon dioxide laser is a very effective tool for treating diseases of the perianal region. The skin of the perianal region is thin and sensitive. The carbon dioxide laser offers a‘no touch’ method of excising these lesions, which helps decrease postoperative discomfort and irritation. The carbon dioxide laser is very effective in controlling hemorrhage from vessels smaller than 0.5 mm. This is sufficient in controlling most hemorrhage caused from the rich blood supply of the perianal region. The perianal region is contaminated with bacteria. The carbon dioxide laser photothermally vaporizes bacteria, so that bacterial numbers are decreased, which helps reduce the risk of postoperative infections. These factors help the patient recover quicker and return to function sooner.
The light emitted from a carbon dioxide laser has a wavelength of 10,600 nm, which is in the far-infrared light spectrum. This wavelength of light is highly absorbed by water, creating a thermal effect. Because all soft tissues in the body are composed mainly of water, the carbon dioxide laser penetrates very shallow into tissue, and there is very little collateral thermal damage. This interaction makes the carbon dioxide laser a useful tool for incising, excising, and photoablating soft tissue and allows for fine, controlled dissection of tissue. The axiom of ‘what you see is what you get’ applies to the properties of the carbon dioxide laser. Finally, the carbon dioxide laser seems to have a lower learning curve when compared with other types of lasers.