Laser & Energy Procedures

Laser and advanced energy devices deliver controlled energy to cut, ablate, coagulate or seal tissue. The device and settings are selected according to the tissue, access route and clinical objective.

Laser surgery

A surgical laser uses focused light energy as an alternative or complement to other instruments. It may be considered for selected skin, oral, upper-airway and endoscopic procedures after evaluation.

• Skin and mass procedures: Selected cyst, wart and mass removals.
• Soft-palate and oral procedures: Selected upper-airway and oral tissue procedures.
• Endoscopic laser applications: Selected nasal, urinary, esophageal or airway procedures where laser access is appropriate.

Endoscopic laser applications

A laser may be delivered through or alongside an endoscope when the access route, tissue and clinical goal make that appropriate. Applications include selected nasal tissue procedures, scar-tissue treatment associated with an esophageal narrowing, urinary stone fragmentation and selected urinary or airway applications. Availability and candidacy require individual review; the same device is not appropriate for every lesion or location.

Advanced energy devices

• Electrocautery and radiosurgery: Energy-based cutting and coagulation during selected procedures.
• Vessel-sealing devices: Instruments designed to seal vessels during open or laparoscopic surgery.
• Ultrasonic instruments: Mechanical and ultrasonic energy for selected dissection and sealing tasks.
• Coblation: Radiofrequency energy in saline for selected soft-tissue applications.

Potential advantages and limitations depend on the procedure, device, tissue and individual patient. Dr. Pedraza discusses why a particular instrument is being considered as part of the surgical plan.

Planning and limitations

Laser and energy devices describe how tissue is handled, not the complete procedure. The underlying diagnosis determines whether imaging, biopsy, open access, endoscopic access or another treatment is needed. Anesthesia, discharge and recovery instructions therefore vary with the operation rather than with the device name alone.