Upload
lvrevathi
View
224
Download
0
Embed Size (px)
Citation preview
7/23/2019 Surgical Co2 Laser
1/19
Surgical co2 laser
The CO2 laser is used in a broad range of clinical applications. The surgical
laser can augment and, in many instances, even replace traditional
instruments and methods. The Aesculight and Luxar CO2 surgical lasers are
useful in procedures where
!urface penetration is desired"
!oft tissue is the target.
Laser # Tissue $nteraction
Lasers differ from each other by the wavelength of light they produce. The
CO2 laser wavelength of %&,'&& nanometers is highly absorbed by soft
tissues with high water content # see the water absorption spectrum below.
(any tens thousands of CO2 surgical lasers are being used today in surgical
suites around the world.
The Luxar laser is operated in a non#contact fashion. The tip is held close to,
but does not touch, the target tissue. The tissue effects are different from
7/23/2019 Surgical Co2 Laser
2/19
contact lasers, where the primary effect is a result of heat conducted from
the tip to the tissue. The primary determinants of laser effect on tissue are
)avelength"
Tissue type"
*ower density"
+xposure time.
+xact guidelines on various surgical laser techniues are presented in the
Aesculight Laser Operator-s (anual as well as Luxar Laser Operator-s
(anual.
Laser *hysiology
The CO2 laser is cleared by the /A for soft tissue procedures only. The
laser is an effective hemostatic tool for vascular tissue. )hen the CO2 laser
is used for muscle dissection there is minimal heating or contraction of the
muscle. This helps facilitate certain procedures and reduce post#surgical pain
and edema. *roper use of Luxar CO2 surgical lasers within the /A#cleared
indications for use may offer some of the following advantages over
conventional treatment
$mproved access to some areas, compared to the scalpel"
0educed operative time in some procedures"
Tissue sculpting ability" +asier removal of lesions without distortion of surrounding tissue"
Less bleeding, often with less trauma"
Less need for suturing"
0educed postoperative pain and discomfort"
(inimi1ed ecchymosis and edema.
7/23/2019 Surgical Co2 Laser
3/19
*atients often report less postoperative pain with laser wounds. The laser is
more versatile than conventional surgical instruments because it can
$ncise or excise"
apori1e or ablate"
*rovide hemostasis.
As is the case with any other surgical instrument, no one should use the
Luxar surgical laser, or any other medical laser, without specific training in
both medical laser use and laser safety.
The CO2 laser is not cleared by the /A for use on bone or in hard tissueprocedures in the 3nited !tates.
Laser surgery benefits for the clinician
Improved visibility of the surgical field
The laser beam seals capillaries and small blood vessels as it 4cuts4 the
tissue. This dramatically reduces bleeding, resulting in a much drier and
clearer surgical site. $n addition, the Luxar surgical laser does not use the
very distracting aiming beam usually associated with outdated articulatedarm CO2 laser systems.
Reduction of procedure time
7/23/2019 Surgical Co2 Laser
4/19
The hemostatic effect of the CO2 laser beam and the improved visibility of
the surgical field reduce the time needed to perform the surgery, and may
also reduce the need for sutures, bandaging, and other after#care measures.
Pinpoint accuracy and control
The diameter of the beam may be ad5usted down to a small fraction of a
millimeter or expanded to address a much wider swath. The power of the
beam may be set for rapid removal of relatively large tissue amounts, or
ad5usted to remove only one or two cell layers at a time.
Increased surgical capabilities
Laser surgery changes the character of many procedures by ma6ing them
simpler or by reducing ris6. This opens up the possibility of expanding the
clinician-s surgical repertoire to include procedures that are not practical
with conventional scalpel#based techniues.
Laser surgery benefits for the patient
Less Pain
The laser seals lymphatics and nerve endings as it cuts, resulting in less
edema and pain that leads to a more comfortable post#operative recovery.
Reduced risk of infection
CO2 laser surgery is a 4no touch4 technology. The laser beam 6ills bacteria
in its path, producing a saniti1ing effect.
Quicker recovery time
0educed ris6 of infection, less bleeding, less swelling, and less pain often
allow the patient a more rapid return to normal activities.
7/23/2019 Surgical Co2 Laser
5/19
Lasers in Cancer Treatment
The word LA!+0 actually stands for Light mplification by Stimulated
!mission of Radiation.
Laser light is different from regular light. The light from the sun or from alight bulb has many wavelengths and spreads out in all directions. Laser
light, on the other hand, has a single wavelength and can be focused in a
very narrow beam. This ma6es it both powerful and precise. Lasers can be
used instead of blades 7scalpels8 for very careful surgical wor6, such as
repairing a damaged retina in the eye or cutting through body tissue.
Types of lasers
Lasers are named for the liuid, gas, solid, or electronic substance that is
used to create the light. (any types of lasers are used to treat medical
problems, and new ones are being tested all the time. Today, 9 6inds of
lasers are commonly used in cancer treatment. carbon dioxide 7CO28, argon,
and the neodymium yttrium aluminum garnet 7:d;A
7/23/2019 Surgical Co2 Laser
6/19
through thin flexible tubes called endoscopes to get to hard#to#reach parts
inside the body, such as the swallowing tube 7esophagus8 or large intestine
7colon8. This light can also travel through optical fibers, which can be bent
and placed into a tumor to heat it up and destroy it.
$ther lasers used in medicine
!ome newer types of lasers B the erbium yttrium aluminum garnet
7+r;A
7/23/2019 Surgical Co2 Laser
7/19
!trict safety precautions must be followed in the operating room when
lasers are used. or example, the entire surgical team and the patient
must wear eye protection.
The effects of some laser treatments may not last long, so they may
need to be repeated. And sometimes the laser cannot remove all of the
tumor in one treatment, so more treatments may be needed.
Treating cancer +ith lasers
Lasers were first used on s6in tumors in %E'%. Today one of the most
common medical uses of lasers is in cancer treatment. They can be used in 2
ways to treat cancer
To shrin6 or destroy a tumor with heat
To activate a chemical B 6nown as aphotosensitizing agentB that6ills only the cancer cells. 7This is calledphotodynamic therapyor
PDT.8
Though lasers can be used alone, they are most often used along with other
cancer treatments, such as chemotherapy or radiation.
Lasers are also being studied for treating or preventing side effects of
common cancer treatments. or instance, some studies are loo6ing at how
lasers might be used to prevent or treat severe mouth sores caused by
chemotherapy, and how they may be used to treat the swelling7lymphedema8 that can result after breast surgery. (ore research is needed to
learn about these possible uses for lasers.
Shrinking or destroying tumors directly
The CO2and :d;A< lasers are used to shrin6 or destroy tumors. They can
be used with thin, flexible tubes called endoscopesthat let doctors see inside
certain parts of the body, such as the bladder or stomach. The light from
some lasers can be sent through an endoscope fitted with fiber optics. This
lets doctors see and wor6 in parts of the body that could not otherwise bereached except by ma5or surgery. $t also allows very precise aim of the laser
beam.
Lasers can be used with low#power microscopes, too. This gives the doctor a
larger view of the area being treated. )hen used with a an instrument that
allows very fine movement 7called a micromanipulator8, laser systems can
7/23/2019 Surgical Co2 Laser
8/19
produce a cutting area as small as 2&& microns in diameter B less than the
width of a very fine thread.
Lasers are used to treat many 6inds of cancer. $n the intestines or large
bowel, lasers are used to remove polyps, small growths that may become
cancer. The CO2laser can be used to treat pre#cancerous tissue and very
early cancers of the cervix, vagina, and vulva.
Lasers are also used to remove tumors bloc6ing the swallowing tube
7esophagus8 and large intestine 7colon8. This does not cure the cancer, but it
relieves some symptoms, such as trouble swallowing.
The :d;A< laser has also been used to remove cancer that has spread to
the lungs from other areas. This helps patients avoid surgery that would
reuire removing large sections of lung. This type of laser cannot curecancer, but it can improve breathing and other symptoms in many patients.
Cancers of the head, nec6, airways, and lungs can be treated 7but usually not
cured8 with lasers. !mall tumors on the vocal cords may be treated with
lasers instead of radiation in some patients. As with tumors bloc6ing the
esophagus, tumors bloc6ing the upper airway can be partly removed to ma6e
breathing easier. Dloc6ages deeper in the airway, such as in the branches of
the breathing tubes 7bronchi8, can be treated with a flexible, lighted tube
called a bronchoscope and an :d;A< laser.
Laser-induced interstitial thermotherapy7L$TT8 is based on the same idea
as a cancer treatment called hyperthermia. Doth methods use heat to help
shrin6 tumors by damaging cells or depriving them of the things they need
to live 7li6e oxygen and food8. $n L$TT, the laser light is passed through a
fiber optic wire and right into a tumor, where it heats up, damaging or 6illing
cancer cells. L$TT is sometimes used to treat tumors in the liver.
Photodynamic therapy
$n photodynamic therapy 7*/T8, a special drug called a photosensiti1ingagent is put into the bloodstream. Over time it is absorbed by body tissues.
The drug stays in or around cancer cells for a longer time than it does in
normal tissue. !hining a certain 6ind of light on the drug that is in the cancer
cells causes a chemical reaction that then 6ills the cancer cells.
7/23/2019 Surgical Co2 Laser
9/19
*hotosensiti1ing agents are Fturned onG or activated by a certain wavelength
of light. or example, an argon laser can be used in */T. )hen cancer cells
that contain the photosensiti1ing agent are exposed to red light from this
laser, it causes the chemical reaction that 6ills the cancer cells. Light
exposure must be carefully timed so that it is used when most of the agent
has left healthy cells, but is still in the cancer cells.
*/T can have some advantages over other treatments. Cancer cells can be
singled out and destroyed but most normal cells are spared. The damaging
effect of the photosensiti1ing agent happens only when the drug is exposed
to light, and the side effects are fairly mild.
!till, */T as it is currently used is not without its problems. Argon laser
light cannot pass through more than about % centimeter of tissue 7a little
more than one#third of an inch8, which means it=s not as useful againstdeeper tumors. And the photosensiti1ing agents used today can leave people
very sensitive to light, causing sunburn#li6e reactions after only very brief
sun exposure. This can greatly limit the patient=s activities until the body
gets rid of the drug, which often ta6es wee6s.
*/T is sometimes used to treat cancers and pre#cancers of the swallowing
tube 7esophagus8, and certain 6inds of lung cancer that can be reached with
thin, flexible tubes calledendoscopes. */T is being studied for use in other
cancers, such as those of the brain and prostate. 0esearchers also are loo6ing
at different 6inds of lasers and new photosensiti1er drugs that might wor6even better.
.
The outlook for lasers in cancer treatment
Decause of their power and precision, lasers are well#suited for certain
cancer surgeries, and doctors are trying to find new and better ways to use
them. As more cancer surgeons learn to use lasers, as the lasers themselves
become smaller and cheaper, and as technology improves to allow tumorsdeep within the body to be treated, lasers will probably be used more often
as part of cancer treatment.
Lasers in Cancer Treatment
7/23/2019 Surgical Co2 Laser
10/19
Key Points
Laser light can be used to remove cancer or precancerous growths or to relieve
symptoms of cancer. $t is used most often to treat cancers on the surface of the
body or the lining of internal organs.
Laser therapy is often given through a thin tube called an endoscope, which can
be inserted in openings in the body to treat cancer or precancerous growths insidethe trachea 7windpipe8, esophagus, stomach, or colon.
Laser therapy causes less bleeding and damage to normal tissue than standard
surgical tools do, and there is a lower ris6 of infection.
owever, the effects of laser surgery may not be permanent, so the surgery may
have to be repeated.
7/23/2019 Surgical Co2 Laser
11/19
Laser instruments for gynaecology
The CO2laser wavelength is carried via hollow tubes, waveguides, and mirrors.
Conventional fiberoptics are not currently available for clinical use. The
laparoscopic use of this wavelength is possible with the use of a focusing cube
and an operative laparoscope or with a variety of waveguides designed for
multi-puncture laparoscopic applications. The focusing cube permits the use of
the CO2laser in a free beam mode for cutting, vaporization, and coagulation of
tissue. The focusing cube also is capable of transmitting an aiming beam. This
feature makes it easier for the surgeon to direct the laser energy to the desiredtarget. variety of procedures, such as myomectomy, partial oophorectomy,
resection and ablation of endometriomas, adhesiolysis, and even
cholecystectomy have been accomplished successfully with this delivery
system. Cholecystectomy re!uires a "c#ernan-type approach. The successful
use of this approach re!uires knowledge and facility with the operative
laparoscope and the surgeon$s ability to visualize the desired target and
maneuver a micromanipulator or %oystick. The surgeon can alter the tissue
effect by focusing or defocusing the laser beam as well as varying the laser
wattage selected. &aser waveguides are hollow tubes with mirror-like surfaces
that reflect the CO2wavelength. 'aveguides are available in both rigid and
fle(ible versions and can be used to achieve a spot size )ie, burn or incision*
that is in the range of +.mm to 2.2mm. s a general principle, the waveguide
is used in a noncontact fashion, particularly because tissue contact can
obstruct the waveguide and li!uid can be drawn into the hollow waveguide by
7/23/2019 Surgical Co2 Laser
12/19
capillary action. The result of these events is the irreversible destruction of the
waveguide. ecent developments include the Omniguide, which is a small-
diameter solid chalcogenide glass waveguide and which is currently being used
in otolaryngology and neurosurgical applications.
The successful use of this laser for dissection and hemostasis re!uires that the
surgeon be adept and e(pert with the laser, as this will affect the ability to
dissect tissues and achieve an ade!uate degree of hemostasis. oth the
focusing cube and waveguide systems re!uire a direct line of sight or the use of
angled mirrors. This further complicates the maneuverability of these devices
more so than fiber capable lasers and conventional instruments. oth
configurations re!uire flowing gas to cool the system and to prevent vaporized
tissue plume from being thrown into the device. The most fre!uently used
purge gases are argon and carbon dio(ide. /igh CO2gas flow rates can actuallyabsorb the laser energy and reduce its efficiency )ie, the transmission of
energy from the laser to the tissue*. Therefore, lower flow rates )ie, 0&1min*
are suggested. ome laser systems are e!uipped with a nitrogen purge gas
system. The surgeon should 3OT use nitrogen during laparoscopy, because its
absorption from the peritoneum can cause 4the bends.5
The optimal use of the CO2laser for laparoscopic or open use is achieved when
the beam is oriented perpendicular to the desired target. /emostasis is
enhanced by tissue compression, the use of epinephrine-containing local
anesthetic solutions and the ability of the operator to recognize the presence
of a vessel prior to its division. 6nder these conditions, the surgeon defocuses
the laser )ie, moves the handpiece, waveguide, or operating laparoscope
farther away from the target* and then applies short bursts of energy to the
vessel in the area to be divided. This maneuver heats and coagulates the
vessel, thereby enabling its division by the focused beam. The surgeon should
use the highest power setting with which he or she is comfortable, because this
will enable more efficient cutting, better hemostasis, and less thermal in%ury
to the wound edges by minimizing conductive and radiative heat loss into thewound. 7ntermittent evacuation of the vaporized tissue plume or the use of a
recirculating filtration system assure a clear field of view and prevent
absorption of to(ic products of combustion by the patient. This problem is
identical in magnitude and to(icity to the vaporized tissue plume created
byany electrosurgical, thermal, or laser source. imilarly the 4smoke5 should
7/23/2019 Surgical Co2 Laser
13/19
not be vented into the operating room, because it is considered hazardous for
O personnel. O/137O/ has written regulations that re!uire that O staff
be protected from vaporized tissue plume regardless of its source.
ARGON LASER
The argon laser has been used e(tensively for gynecologic laparoscopic
procedures in the past.0+,887t has largely been replaced by other technologies
today. This laser produces light in the visible portion of the spectrum. This
laser actually produces 9 lines )wavelengths*. /owever, the ma%ority of the
laser output is in the blue-green spectrum )wavelength : ;
7/23/2019 Surgical Co2 Laser
14/19
the more selective absorption of the wavelength in hemoglobin enables the
surgeon to photocoagulate vessels before their division by bringing the fiber
away from the tissue surface. This maneuver is similar to defocusing the free
beam. The defocused mode is used to vaporize endometriomas. ome
manufacturers produce a variety of sculpted fibers and metal-%acketed fiberdelivery systems. These fibers are constructed to be more durable and work
4more like a scalpel5 due to absorption of some of the laser energy in the fiber
resulting in heating of the fiber. This produces an optically driven cautery
effect. o-called bare or urologic fibers are easily used and are cleaved and
stripped as the fiber end degrades with use. Optimal cutting occurs by using
the tip of the fiber either end-on or obli!ue to the plane of the dissection.
ecause these wavelengths are color dependent, the surgeon should note that
white or lightly colored tissue, such as meniscus and tumor implants, will notcut efficiently and will not be vaporized )ablated* unless they are first painted
with 7ndia ink, indigo carmine dye, or another e(ogenous chromophore.
droplet of blood placed on the surface is sometimes effective for this purpose.
lackened or ebonized instruments and the use of optical backstops are
re!uired to prevent beam reflection and iatrogenic in%ury.
One of the main drawbacks of the laparoscopic use of the argon laser is the
camera1eye safety filter. The eye and camera filters must block the 9 lines )ie,
wavelengths* produced by the laser. These filters are usually a deep orange
color and absorb 8+A to 9+A of the visible spectrum. s a result, the color
balance of the image is distorted, and the need for a high-powered light source
is critical to the surgeons$ ability to visualize the operative field. "any laser
systems have intermittent shutter mechanisms that place the filter in the
visual field only while the laser is actually being fired. The surgeon must be an
e(pert at the local anatomy and the details of the procedure prior to
attempting to work with this laser. This laser system is rarely used today due to
the availability of #TB and #B laser systems, which are much less cumbersome
to use.
Nd: YAG LASER
The neodymium ?@ laser produces near infrared light at a wavelength of
0+9+nm. This wavelength is carried via conventional fiberoptics, and, like
visible light lasers, the energy will be transmitted through water. The energy
can be applied to tissues with a wide array of delivery systems including
7/23/2019 Surgical Co2 Laser
15/19
cleaved bare fibers )ie, urologic fibers*, polished @7 fibers, sapphire tips )ie,
the delivery device that is marketed as the Contact &aser*, sculpted fiber )eg,
"icrocontact tip and various other proprietary versions of this technology*, as
well as free beam via a micromanipulator or "icroslad unit.0,8, ?@ laser is intensely absorbed by tissue protein andchromophores and is highly scattered in tissue. These properties result in deep
penetration of the energy and much greater damage below the tissue than can
be appreciated at the surface. This makes noncontact )ie, @7 fiber, free beam*
and bare-fiber applications of the 3d> ?@ laser e(tremely dangerous unless
the surgeon has a thorough understanding of the laser-tissue interaction and
orients the beam in a direction that would reduce the likelihood of damaging
nearby structures. pecialized angled delivery or fibers have been
developed for use in photocoagulation of the prostate. These devices pro%ect
the beam at right angles to the long a(is of the probe, thereby allowing the
prostatic tissue to be photocoagulated or vaporized. These applications re!uire
knowledge of the anatomy and tissue effects. The surgeon orients the laser
output toward the 0+>++ and 02>++ positions and will fire the laser at a preset
energy for a specified length of time based on the volume of tissue to be
photocoagulated.
The 3d> ?@ laser is a poor cutting instrument when it is used in a noncontact
mode. The development of sapphire tips and sculpted fiber technologies
facilitate use of this laser in contact with tissue. Dree-beam type applications
can result in damage to 0cm to 2cm of liver tissue and the photocoagulation of
vessels up to ;mm in diameter. /owever, the sapphire tip technology is a
combination of a combined thermal and optical interaction with tissue. "uch of
the 3d> ?@ energy is absorbed by the sapphire or fiber tip and converted to
heat. The result is to produce optically driven cautery. The temperature of the
tip can be tightly regulated for some applications. These instruments improve
the cutting ability of the laser, but the tissue damage and the e(tent of
coagulation are reduced dramatically. The histology of these devices is !uite
similar to the results produced by electrosurgical devices. ince their main
tissue interaction is thermal cautery, the rate of incision and the degree of
hemostasis can be reduced when these devices are used in the presence of
irrigating fluids or in the a!ueous environment of the bladder or %oint space.
7/23/2019 Surgical Co2 Laser
16/19
olography for nondestructive testing
Optical olographic techniues can be used for nondestructive testing of materials
7:/T8. :onoptical olography techniues include Acoustical, (icrowave, H#0ay and
+lectron beam olography.:/T essentially measures deformations on the surface of the ob5ect. owever, there is
sufficient sensitivity to detect sub# surface and internal defects in metallic and composite
specimens.$n :/T techniues, the test sample is interferometrically compared with the sample
after it has been stressed 7loaded8. A flaw can be detected if by stressing the ob5ect it
creates an anomalous
deformation of the surface around the flaw.Optical holography is an imaging method, which records the amplitude and phase of light
reflected from an ob5ect as an interferometric pattern on film. $t thus allows
reconstruction of the full 9#/ image of the ob5ect. $n :/T, the test sample isinterferometrically compared in two different stressed states.
!tressing can be mechanical, thermal, vibration etc. The resulting interference pattern
contours the deformation undergone by the specimen in between the two recordings.
!urface as well as subsurface defects show distortions in the otherwise uniform pattern.$n addition, the characteristics of the component, such as vibration modes, mechanical
properties, residual stress etc. can be identified through holographic inspection.
Applications in fluid mechanics and gas dynamics also abound.The light used to illuminate the surface of the specimen must be coherent, which means
that it must also be monochromatic, and the only practical source is a laser. +ach type of
laser emits a
7/23/2019 Surgical Co2 Laser
17/19
characteristic wavelength, e.g. a helium#neon laser emits '92.>nm" a ruby laser emits
'[email protected]. Laser diodes are nowadays an exciting and compact alternative. $ndeed,
holography using laser pointers have also been demonstrated.igh#resolution films are another necessity for holography. )ith the advent of CC/ and
digital image processing, digital holographic interferometry offers tremendous flexibility
and real#time visuali1ation.urthermore, image#processing schemes can provide computerised analysis of patterns
for automated defect detection and analysis.
inally since intricate interferometric patterns have to be recorded, vibration isolation isalso reuired.
:ovel schemes have been proposed, including use of pulsed lasers to record holograms in
factory environments.
Advances and developments in lasers, computers, and recording materials introduce newtechniues such as electronic 7or T8 holography, multi#wavelength recording,
thermoplastic medium, timeaveraged holography, dynamic holographic interferometry,
cineholography, and digital holography with each new development. (ethods that once
held only academic interest often become practically viable with these developments inhardware and software.
:/T is widely applied in aerospace to find impact damage, corrosion, delamination,debonds, and crac6s in high performance composite aircraft parts as well as turbine
blades, solid propellant roc6et motor casings, tyres and air foils. Dut olography is also
finding new applications in commercial and defense related industries to investigate andtest ob5ect ranging from microscopic computer chips and circuits to cultural articles,
paintings and restoration.
olographic nondestructive testing techniues 7:/T8 are used to locate and evaluatecrac6s, disbonds, voids, delaminations, inhomogeneity and residual stresses in a test
sample without destruction of the sample. The holographic interferometry techniues are
applied for nondestructive testing of materials.
The :/T techniues can be used for the testing of laminated structures, turbine blades,
solid propellant roc6et motor casings, tyres and air foils. These techniues are also usefulin medical and dental research. $n :/T techniues, the test sample is
interferometrically compared with the sample after it has been stressed 7loaded8. A flaw
can be detected if by stressing the ob5ect it creates an anomalous deformation of the
surface around the flaw. The holographic interferogram will show up the anomalousdeformation by an abrupt change in the shape of the interference pattern.
The ob5ect can be stressed by mechanical stressing, pressure or vacuum stressing, thermal
stressing, vibrational stressing and magnetic stressing. The stressing of the ob5ect can
create gross deformation and rigid body motion of the ob5ect. This will produce fineinterference fringes in the interferogram if the test area is large. $n such a situation, the
interference fringes around the flaw will be very fine and it would not be detected by
unaided eye. Dy using fringe control methods, the effects of gross deformation and rigid
body motion can be compensated.
7/23/2019 Surgical Co2 Laser
18/19
Applications of holographic interferometry
ield Applications
Aerospace /efects in honeycomb plates
Testing of construction materials,Testing of welding methods
$nspection of roc6et bodies
low visuali1ation in wind tunnelsibration modes of turbine blades
Automobiles Testing of oil pressure sections
Testing of welding methods0esearch in construction of
automobile bodies
Construction of engines
(achine tools and precision
instruments
(easurement of deformations of machine parts,
5igs and tools(easurement inside cylinders
(easurements of stiffness 7heat, static ordynamic8
Analysis of construction of instruments and tools
+lectrical and electronic
industries
ibration modes of turbine blades, motors,
transformers, loudspea6ersTesting of welding and adhesion
Testing of circuit parts
Analysis of audio euipmentsLea6 test of batteries
Civil +ngineering Analysis of constructions
/esign of pipes0esearch in concrete.
7/23/2019 Surgical Co2 Laser
19/19
Chemical industry (easurement of mixed fluids. Tyre, rubber and
:/T of tyres, plastics
Testing of molded products
(easurement of adhesion defects
(edicine (easurement on living bodies
Chest deformation due to inhalation(easurement on teeth and bones
Testing materials for dental surgery
Testing of urinary trac6 (easurement on eyes, ears, etc.
(usical instruments (easurement of vibration modes
Cultural articles and paintings :/T and restoration.