As in small animals, orthopedic applications
in large animals have been limited. As delivery methods improve
and systems with appropriate wavelengths (Ho:YAG at 2.1 micrometers
and Er:YAG at 2.94 micrometers) become more affordable for veterinarians,
applications will undoubtedly increase as they have in human
medicine, especially in equine surgery. Use of the CO2 laser
for intra-articular cartilage vaporization has had favorable
results, although delivering this wavelength into a joint is
report on the use of the Ho:YAG for "low-power"
stimulation of healing articular cartilage in the horse has generated
interest in possible clinical applications in both human and
veterinary medicine. Low-power infrared laser energy, which could
accelerate the healing of sutured wounds, has been advocated
as an adjunct to postsurgical therapy for equine trauma and for
soft-tissue conditions such as teat lacerations in cattle.
recently described minimally invasive standing method for treating
angular limb deformities in foals using the Nd:YAG laser shows
excellent potential.As biomedical laser technology merges with
military and industrial advances, improvements in existing devices
as well as the development of new ideas will continue at astonishing
rates. Recent changes in health care philosophy accompanied by
more limited funding sources mandate the use of minimally invasive
and minimally damaging procedures that should lower overall costs.
Veterinary medicine can and should be in the forefront during
these exciting times, adding an essential dimension to the development
of cutting-edge technology.
Research on basic laser-tissue interaction
and selective tissue destruction is increasingly important for
achieving the therapeutic goal of minimally invasive procedures
for a variety of conditions. Destruction of alimentary tract
mucosa is possible using holmium laser energy endoscopically.
Intersitial laser hyperthermia to treat malignant tumors will
become an effective part of the veterinary oncologist's armamentarium,
as will expanded use of photodynamic therapy.
using appropriate chromophores for selective tissue destruction
and sterilization/disinfection is currently being proven an effective
treatment for tumors and trauma in clinical and laboratory settings.
Minimally invasive urologic techniques for ablation of bladder,
urethral and prostatic conditions in small animals will become
more common as technology is refined, smaller endoscopes are
developed, delivery systems are improved and new laser wavelengths
Laser lithotripsy is now possible using
both visible and infrared wavelengths. This technology may eventually
allow minimally invasive removal of kidney stones and gallstones
in animals. Fusion or welding of blood vessels, alimentary tract,
ureter or urethra, skin and even bone may be possible. Application
of lasers for micromanipulation of gametes and improvement of
fertilization and hatching rates during in vitro fertilization
are nearly clinical veterinary realities. The use of lasers for
soft-tissue dental procedures is already feasible and, with continuing
investigations, hard-tissue dental procedures should become so.
The Ho:YAG and Er:YAG have already been used for enamel resurfacing
and ablation in animals.The existence of diode lasers with wavelengths
from the ultraviolet to the far-infrared means that user-friendly,
durable, portable, less-expensive laser systems are definitely
on the horizon. Currently, FDA-approved high-power diode lasers
are available for both clinical and investigational use from
manufacturers such as SDL, Diomedics, Cynosure and Applied Optronics.
At this point, diode laser development
and technologies that provide smaller but more durable clinical
devices for multiple applications seem to hold the greatest promise.
In addition, the use of lasers in diagnostic tools and sensors
is one of the fastest-growing branches of biomedical laser development.
Minimally invasive methods for detecting malignant cells, abnormal
tissue and metabolites have tremendous potential. Laser diagnostic
technologies could have a significant impact on veterinary medicine
if costs for such devices become resonable.
In 1968, the removal of a vocal cord nodule
in a dog demonstrated one of the first practical clinical applications
of the continuous-wave CO2 laser. Since that time, many other
research teams have relied on animal models to determine initial
laser parameters and efficacy of new wavelengths, and for final
evaluation of new surgical procedures prior to use in human medicine.
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