Comparing Surgical CO2 laser technologies to Aesculight

When selecting a CO2 surgical laser for your practice, it is important to select the most reliable and ergonomic laser technology and warranty.

Surgical Lasers - Articulated Arm vs Tipless Handpiece

Figure 1. Shown here are the outdated glass tube articulated arm (left) and 21st century flexible fiber waveguide (right). The flexible fiber allows the hand piece to have a maneuverable, lightweight feel like a scalpel.

 State-of-the-Art American Technology

Luxar lasers were the most popular surgical CO2 lasers in the world from 1990-2005, with over 12,000 units installed, and were the first to feature a flexible waveguide fiber (www.luxarcare.com). The Aesculight laser was designed by Luxar’s chief scientists and engineers, who improved upon the laser technology.

Veterinary Aesculight lasers have many of the same critical components as the Luxar laser. Compared to Luxar lasers, however, new generation Aesculight lasers feature an upgradeable user control panel, more laser pulsing capabilities, disposable-free (tipless) handpieces, and an efficient active cooling heat exchanger, among many other exclusive components. Aesculight lasers includes the following components:

Aesculight Laser Details

Figure 2. The Aesculight surgical CO2 laser system and it’s components.

  1. The all-metal laser tube
  2. Low voltage 32 volts DC and RF power supplies
  3. Forced air heat exchanger
  4. Flexible fiber waveguide laser beam delivery system
  5. Laser power meter
  6. Beam attenuator – shutter (laser turn off safety switch)
  7. Safety devices monitoring the performance of all critical components 1 through 6
  8. Touchsreen user control panel
  9. Software program controlling all the hardware items 1 through 8
  10. Safety ‘watch-dog’ software program monitoring items 1 through 9

How Do Imported Lasers Compare to American-Made Lasers?

Imported lasers often have bulky articulated arms (1980s technology), and fragile, high voltage (over 10,000 volts) glass laser tubes; intense heat is generated by plasma inside the glass tube and could cause it to crack (1960s technology).

 ‘Distal Calibration’

Aesculight is the only veterinary surgical CO2 laser on the market today with the ability to calibrate the laser power, or verify that the power selected on the control panel matches the power that exits the laser hand piece. Calibration can be done at any time by the user through the calibration port on the side of the laser (Figure 2).

Although FDA regulations require all medical lasers to have a built-in power meter (FDA CDRH Title 21 Part 1040.11), some imported lasers do not have this device. When using a laser without a power meter and distal calibration capabilities, the clinician does not have a way to determine how much power is applied to the patient.

Laser Cooling Technology

CO2 lasers are only 10-20 % efficient; hence, 80-90 % of electrical energy is transformed directly into heat inside the laser tube and laser system. This wasted heat needs to be removed, otherwise the laser may overheat. The Aesculight laser system have all metal laser tubes with forced air cooling. Competitors use glass tubes with water cooling. Some of the disadvantages of competitor laser cooling systems include: glass tube fragility and the chore of keeping the water cooling system full.

Beam delivery technology

The ergonomic flexible fiber waveguide CO2 lasers have been popular since the mid-1990s. These long-lasting flexible fibers enable hand pieces to have a scalpel-like feel, enabling pin-point accuracy and accessibility for surgeons. Flexible fibers can be easily calibrated by the user at any time, adding a significant safety benefit.

Articulated arms are an outdated technology, developed in the 1970s-80s. They are not as maneuverable, and allow surgeons limited accessibility and accuracy. Articulated arms can only be calibrated at the manufacturing facility or by field service engineers.

Laser Tube Technology

All-metal RF excited CO2 laser technology (Figure 2) has been dominant in medical, industrial, and military applications since the mid-1990s. This is the only proven technology that allows for fast, inexpensive service in demanding settings.

Antiquated fragile glass tubes (1960s technology) are difficult to service. The very high voltage (over 10,000 volts) needed to operate these lasers often causes damage that calls for expensive laser tube replacement, rather than repair

Laser Warranty

Many imported lasers have laser power monitors and other safety features disabled. Laser performance is not monitored, warranties thus do not cover system deterioration, and distributors can claim arbitrary, long warranty periods.

International Laser Safety Compliance Certifications

Laser Competition Standards of Compliance

Figure 3. Chinese-made surgical CO2 laser’s ‘Attestation of Conformity’ claiming that it complies with European Union (CE) standards for HOUSEHOLD appliances such as hair-dryers.

Many importers misrepresent their products as compliant with relevant international safety regulations. For instance, a Chinese manufacturer presents its surgical CO2 laser as a CE certified product – see Figure 3. Upon closer examination, however, one discovers that 1) CE standards EN 60335-1 and 60335-2-23 quoted in this certificate are only applicable to HOUSEHOLD appliances such as curling irons, hair and hand-dryers, etc; and 2) quoted CE standards explicitly state that they are not applicable to any “appliances intended for medical use”. Unfortunately, numerous North American importers already peddle these and other similar devices to thousands of unsuspecting clinicians.

Surgical CO2 lasers that are not manufactured by a reputable manufacturer must not be purchased.

Conclusion

Aesculight has several advantages over competing laser manufacturers including: laser beam delivery, ergonomics, cooling systems, and safety. It is important to do your research before purchasing a CO2 surgical laser, and to be especially cautious when ordering one from overseas.