21 November 2016
The Carbon Dioxide laser was invented in 1964 by Dr Kumar Patel at the Bell Laboratory in New Jersey. This was the first laser produced from a single gas source.
The CO2 laser, with its long wavelength of 10,600 nm had great affinity for water, which gave it the ability to destroy cells by” PhotoThermoLysis”, ie light converting to heat, which then destroyed the cell.
It took a while before there were medical indications for the CO2 laser and initially, it was used as a “knife”, with the added ability of cauterizing small blood vessels at the same time as cutting tissue. This is a high precision knife and works best with delicate tissues such as in the periorbital area.
Dr Isaac Kaplan a Plastic Surgeon, deserves a lot of credit for the early surgical applications of the CO2 laser.
However, the great advances came with the development of pulsed CO2 lasers. Heat diffusion was a major problem when the CO2 laser was used in its original Continuous Wave form, with resultant difficulty in control of heat and leading to unpredictable results.
The Pulsed CO2 laser enabled the delivery of energy in a period of time faster than the Thermal Relaxation Time of the tissue, thus preventing heat diffusion and a resultant very controlled and predictable outcome.
The initial truly pulsed laser (instead of the earlier”chopped”continuous wave) was the SuperPulsed WaveForm which was faster and more powerful than continuous waveforms. Further improvement came in the form of the UltraPulsed CO2 laser by Coherent ( now Lumenis) which increased power but with more precision and hence minimising thermal injury.
To Follow :
The Clinical Applications of the UltraPulsed CO2 laser