DIODE LASERS IN MEDICINE

MEDICAL APPLICATIONS

5 wavelengths with different radiation power for wide range of

applications:

Microsurgery

Proctology

Vascular (EVLT)

Physiotherapy

ENT

Aesthetic & Plastic Surgery

Podiatry

- CONVENIENCE

Dedicated workstation - perfect convenience for

operation

Small size of the laser and handy grip - easy

transportation, enhance portability

Transportation case – protection during transport

MICROSURGERY

Contact Microsurgery – excision of warts, fibromas, yellow tufts.

Accessories for Microsurgery

Handpiece and tips

Optical fiber 320µm

or 400µm diameter

Safety glasses

DIODE LASERS IN COLOPROCTOLOGY

In proctology lasers are used commonly for the precise excision or vaporization of the

hemorrhoids, fistula, polips and condyloma.

The result of the laser surgery is less discomfort, less medication, and faster healing. A

hospital stay is generally not required. The laser is inherently therapeutic, sealing off

nerves and tiny blood vessels. By sealing superficial nerve endings patients have a

minimum of postoperative discomfort. With the closing of tiny blood vessels, the

proctologist is able to operate in a controlled and bloodless environment.

Laser can be use alone or in combination with other modalities.

Wavelengths: 980nm, 1470nmnm

PROCTOLOGY

• Under LA/GA, laser energy is delivered by conical fiber directly to hemorrhoidal

nodes and they will obliterate from inside and this will help to preserve mucosa

and sphincter structure to an extremely high precision. Laser energy is used to

close off the blood supply nourishing the abnormal growth. The laser energy

induces destruction of the venous epithelium and simultaneous obliteration of the

hemorrhoidal pile by a shrinkage effect.

• Advantage if using laser compare to conventional surgery, fibrotic reconstruction

generates new connective tissue, which ensures that the mucosa adheres to the

underlying tissue. This also prevents the occurrence or recurrence of a prolapsed.

Surgical procedure can be executed in only a few minutes.

Laser treatment of hemorrhoids

• Under LA/GA, laser Energy is delivered, via radial fiber, into the anal fistula

tract and is used to thermally ablate and close off the abnormal pathway.

The laser energy induces destruction of the fistula epithelium and

simultaneous obliteration of the remaining fistula tract by a shrinkage

effect. The epithelialized tissue is being destroyed in a controlled way and

the fistula tract collapses to a very high degree. This also supports and

accelerates the healing process.

• Advantage if using diode laser using radial fibre compare to conventional

surgery is, it give good control to operator, also allows use in convoluted

tract, no excision or splitting Independent on the length of the tract.

Surgical procedure can be executed in only a few minutes.

Laser treatment of

Anal Fistula & Pilonidal Sinus

Main Feature Laser Surgical Procedure

Anaesthesia LA GA

Patient Hospital Stay Day care 3-7 Days

Pain (Post-operative) Low High

Recovery Time 3 Days 10 Days

Recurrence Low High

Complication Low High

TREATMENT OF PILES AND FISTULA

– LASER VS CONVENTIONAL SURGICAL METHODS

Main Feature Surgical Procedure Non-Surgical

Treatments Option Procedure vary as per disease Laser

Anesthesia High Dose Can be done under LA

Patient Hospital Stay More than 24 Hours 2-3 Hours

Invasivness Suture required No suture required

Cost Low High

Pain (Post-ops) High Low

Recovery Time High Back to work within 2-3 hours

Reoccurrence Very High Low

Complication Very High Low

TREATMENT OF PILES AND FISTULA

– LASER VS CONVENTIONAL SURGICAL METHODS

ADVANTAGES IN PILES, FISTULA TREATMENT

High success rate

Low recurrence rate – the comparative rate is much lower than the traditional methods.

Quick treatment – Take less than an hour. Saves tremendous time for you and your patient.

Minimal invasion – just a nick in the skin, so no scar or stitches.

Minimal blood loss. Minimal pain. Less traumatic.

Instant Relief from accompanying symptoms - Since no surgery and extremely less harm to neighboring

tissues, so recovery is fast. Even less pain, bruising and numbness.

OPD procedure performed with Local anesthesia – It’s safer than General anesthesia. There’s nohospitalization, ambulatory.

Quick Recovery - no downtime. Minimal post operative pain. Your patient can walk away post operation

and can quickly regain his normal activity

Greater Surgical Precision.

Reduced Risk of infection.

ACCESSORIES FOR PROCOTOLGY

Slim Radial Fiber for Fistula (400μm fiber

core, 3m long, standard SMA 905

connector with knurl nut, disposable)

Proctology handpiece

Proctology cannula

Proctology Fiber for Hemmorhoids (600μm

fiber core, 3m long, standard SMA 905

connector with knurl nut, disposable)

DIODE LASERS IN PHLEBOLOGY

PHLEBOLOGYTHE NEW ‘GOLD STANDARD’ TREATMENT FOR VARICOSE VEINS

• EndoVenous Laser Treatment (EVLT) was developed in

Europe and the United States in the latter part of the

1990’s as an alternative to traditional ligation and

stripping surgery for treating the underlying cause of

varicose veins. It has a number of major benefits.

EVLT (Endovenous Laser Treatment) is a procedure leading to occlusion of varicose veins. It involvesputting a fiber optic into a saphenous vein through a catheter. Then the laser is turned on and slowlywithdrawed from the vein. Thanks to light-tissue interaction mainly thermal effects occur, the tissue isheated and the walls of the vein shrink, because of alteration of endothelium and contraction ofcollagen.

EVLT – the procedure

EVLT – the procedure

There are two possibilities of performing the treatment: with pulsed and continuous-wave laser operation.

• Using the pulsed operation also the fiber is withdrawedstep by step.

• A better choice is to use continuous-wave laser and towithdraw the fiber also continuously, what provides morehomogenous illumination of the vein, less tissue damagedoutside the vein and better results. The therapy is just abeginning of the occlusion process. After the treatmentthe veins are shrinking for several days or weeks. That’swhy in the long-period observation very good results areobtained.

Comparison of Varicose Veins Treatment –

Laser vs Surgical Procedure

Main Feature Laser Surgical Procedure

Anaesthesia LA GA

Patient Hospital Stay 1 Day 3-5 Days

Pain (Post-operative) Low High

Recovery Time 3 Days 10 Days

Relapse Risk Low High

Complication Low High

Comparison of Varicose Veins Treatment –

Laser vs Non Surgical Procedures

Main Feature Laser Surgical Procedure

Treatments Through Laser (Pin Hole surgery) RF machine (Pin Hole surgery)

Collateral damage Least Very High

Area of treatment 1 cm energy is delivered 7 cm energy is delivered

Treatment of Perforators Yes No

Portability of machine Very Much – (2.5kg) Less – (ranges from 15kg and above)

Technology/Concept Latest Old

Relapse Risk Least High

Complication Least High

Why we choose 1470nm wavelengths?

1470nm vs 980nm

For 980nm the absorption coefficient is higher forhemoglobin than water.

Unlike 980 nm radiation EVLT which needs appropriatepower of 10- 12 watt for a treatment, 1470 nm radiationneeds only 5-8 watt. This low energy level significantlyminimizes adverse effects.

Laser

wavelength

Depth of penetration

in water

Depth of penetration

in hemoglobin

980nm 2cm 0,5 cm

1064nm 7cm 1cm

1320nm 0,6cm -

1470nm 0,03cm -

Why we choose 1470nm wavelengths?

1470nm

The vein structure is mostly water and 1470nm laser iswater specific laser, targeting water as the chromophore toabsorb the laser energy.

Optimal depth of penetration in water (0,03cm), resultingin an optimal vein ablation. The laser energy ispreferentially absorbed in the intracellular water of thevein wall and in the water content of blood.

The irreversible photo-thermal process induced by thelaser energy results in a complete occlusion of the treatedvein.

No risk of damage to surrounding tissues. Less depth ofpenetration adds a safety element.

Benefits of EVLT

MinimallyInvasive

• Reduced risks associated with the technique and reduced complication rates

Easy to learn

• Simplifies the training required and also means that high success rates will be quickly achieved

Quick to perform

• Means more patients can be treated and it also makes good use of resources

No scars

• As well as giving excellent clinical results EVLT is also excellent cosmetically with only a tiny skin mark as the access point

Localanaesthe

-tic

• EVLT can be done under purely local anaesthetic givingreduced risks and making it ideal for patients who would bea poor surgical risk. It also has rapid recovery times and nooperating theatre is needed

Before After

Benefits of EVLT

Day caseprocedure

• With local anaesthetic EVLT is a true ‘walk-in walk-out’ day case procedure

Rapidrecovery

time

• This is especially accepted by patients who are self employed as they can return to work one or two days after treatment.

Reducedpost

operativepain

• The levels of pain will be lower than usual after surgery and if any pain relief is needed it will just be OTC non-aspirin analgesics

Few

complica-

tions

•This will benefit the patient, the clinician and the medical facility. Varicose vein surgery is the No.1 cause of medical litigation in vascular surgery and EVLT should reduce this

Benefits of EVLT

Use of Laser

• Especially in the private sector the use of a laser for a procedure will attract patients.

Wide rangeof applica-

tions

• As well as treating the Greater (Long) Saphenous veinEVLT can also be used for the Lesser (Short) SaphenousVein and other large truncal varicosities. It can besuitable for up to ~ 80% of varicose vein patients.

No surgery at the groin

• If surgery is required round the groin at a later date therewill be no scar tissue. In addition EVLT can be helpful intreating some patients who have recurrent diseasefollowing previous surgery.

Localanaesthetic

• EVLT can be done under purely local anaesthetic givingreduced risks and making it ideal for patients who wouldbe a poor surgical risk. It also has rapid recovery timesand no operating theatre is needed

EVLT - accessories

With one specially chosen wavelength of 1470nm

Radial optical fiber:

400µm or 600µm

disposable

Bare optical fiber:

400µm or 600µm

disposable or reusable

(up to 10 sterilizations)

Catheter set for radial fibers 6F

( sheath introducer, dilator,

guidewire, puncture needle)

EVLT Catheter (14G, 70cm

or 100cm long, Seldinger

puncture needle 18G –7cm,

Dilator 7F – 10 cm, Guide

wire 0.035’’ - 150cm J-tip)

Lock

Adapter for

EVLT

Catheter

EVLT series - advantages

Lightest Diodelaser

Equipment

• The Lasotronix Smart M 1470 Watt varicose vein diode laser is the lightest diodelaser machine. It weighs just 2.5kg against other 8-10 kg devices which makes iteasy to carry while consulting & enhance your efficiency.

Pre-set Procedures and

Customized Programmes

• Lasotronix Smart M 1470 15 watt diode laser has inbuilt pre-set programs & options for customized program as per your treatment plan.

Large Touch-screen LCD Multilingual

Display

• A large LCD Screen display information about parameter of chosen procedure (power, time of work and energy) so as to help easy monitoring & smooth functioning.

Low Operating

Cost

• Lasotronix Smart M 1470 15 watt diode laser runs on very low operating cost.

Security

• Emergency laser Stop button. Error warning Alert e.g., optic fiber missing, interlock is open etc. helps to pinpoint exact problem.

Patient Data Storage

• Easy to store & retrieve patient database which helps to patient follow up & build case study. Easy to navigate to find patient history. All patient data is stored in USB portable memory –Smart Key. Smart M 1470nm can store up to 1000 patient data

EVLT series - advantages

Wavelengths: 808nm, 1064nm

Set of therapeutic

tips for rehabilitation

High Power Physiotherapy – stimulating the physiological processes at the cellular

receptors combined to the stimulation of the nerve. These processes are possible through

the use of high-power radiation at much wider field of operation than before. It allows

you to carry out treatments with unprecedented speed and depth of penetration in

terms of:

- pain therapy

- treatment of inflammatory

- acceleration of wound healing

- treatment of trigger points

PHYSIOTHERAPY

ENT AND OPHTHALMOLOGY

Dacryocystorhinostomy (DCR) laser surgery is a procedure that aims to eliminate fluid and mucus retention within

the lacrimal sac, and to increase tear drainage for relief of epiphora. In comparison to the classical treatment, the

one performed with SMARTM laser characterizes by a small traumatic, is almost bloodless, does not require sewing

and gives less complications.

Ear Cysts

Accessory auricle

Tumors of the inner

ear

Hemangioma

Myringotomy

Cholesteatoma

Tympanitis

Nose Nasal polyp, rhinitis

Turbinate reduction

Papilloma

Cysts & Mucoceles

Epistaxis

Stenosis & synechia

Sinus surgery

Dacryocystorhinostomy ( DCR )

Throat Uvulopalatoplasty ( LAUP)

Tonsillotomy

Glossectomy

vocal cord polyps

Epiglottectomy

Strictures

Wavelengths: 635nm, 980nm

Contact ENT - fiber in contact with the tissue can be used for cutting, notching, cutting out or

coagulating tissue. This results in the narrow field of coagulation.

Contactless ENT - laser is used contactless for

evaporation and deeper coagulation of the tissue

from 1mm to 3mm:

− Evaporation of the tumors which narrows the

bronchial lights. −

− Treatment of the pathological changes within

the area of vocal cords

ENT AND OPHTHALMOLOGY

Accessories for ENT

Set of handpieces

for ENT

Dermosurgery, 980nm/1470nm

Spider veins, 980nm

Lioplysis, 1470nm

Treatment of diaphoresis, 1470nm

Variable zoom handpiece

(for teleangiectasia, beam

spot diameter regulated:

0.5mm - 3mm)

DERMATOLOGY

Dermosurgery, 980nm/1470nm

Spider veins, 980nm

Lioplysis, 1470nm

Treatment of diaphoresis, 1470nm

DERMATOLOGY

Dermosurgery, 980nm/1470nm

Spider veins, 980nm

Lioplysis, 1470nm

Treatment of diaphoresis,

1470nm

Laser lipolysis is the latest technology in fat reduction,

which uses laser to dissolve fat, the cell membranes

are broken up during this process. The thin fat lysate

is released and it is either resorbed naturally or

extracted manually by suction.

DERMATOLOGY

PODIATRY

Nail fungus – onychomycosis removal by irradiation of an infected nail plate also by

using a special handpiece without the need to remove the nail.

Wavelengths: 1064nm

Procedures under further investigation.

THANK YOU FOR YOUR ATTENTION