Advantages of laser surgery
Often referred to as bloodless surgery, laser procedures usually involve less bleeding than conventional surgery. The heat generated by the laser keeps the surgical site free of germs and reduces the risk of infection. Because a smaller incision is required, laser procedures often take less time (and cost less money) than traditional surgery. Sealing off blood vessels and nerves reduces bleeding, swelling, scarring, pain, and the length of the recovery period.
Disadvantages of laser surgery
Although many laser surgeries can be performed in a doctor’s office, rather than in a hospital, the person guiding the laser must be at least as thoroughly trained and highly skilled as someone performing the same procedure in a hospital setting.
The American Society for Laser Medicine and Surgery urges that:
• All operative areas be equipped with oxygen and other drugs and equipment required for cardiopulmonary resuscitation (CPR).
• Non-physicians performing laser procedures be properly trained, licensed, and insured.
• A qualified and experienced supervising physician be able to respond to and manage unanticipated events or other emergencies within five minutes of the time they occur.
• Emergency transportation to a hospital or other acute care facility (ACF) be available whenever laser surgery is performed in a non-hospital setting.
Diagnosis / Preparation
Because laser surgery is used to treat so many diverse conditions, the patient should ask the physician for detailed instructions about how to prepare for a specific procedure. Diet, activities, and medications may not have to be limited prior to surgery, but some procedures require a physical examination, a medical history, and conversation with the patient that: • enables the doctor to evaluate the patient’s general health and current medical status
• provides the doctor with information about how the patient has responded to other illnesses, hospital stays, and diagnostic or therapeutic procedures
• clarifies what the patient expects the outcome of the procedure to be
Aftercare
Most laser surgeries can be performed on an outpatient basis, and patients are usually permitted to leave the hospital or medical office when their vital signs have stabilized. A patient who has been sedated should not be discharged until recovery from the anesthesia is complete, unless a responsible adult is available to accompany the patient home.
The doctor may prescribe analgesic (pain-relieving) medication, and should provide easy-to-understand, written instructions on how to take the medication. The doctor should also be able to give the patient a good estimate of how the patient’s recovery should progress, the recovery time, and what to do in case complications or emergency arise. The amount of time it takes for the patient to recover from surgery depends on the surgery and on the individual. Recovery time for laser surgery is, for the most part, faster than for traditional surgery.
Risks
Like traditional surgery, laser surgery can be complicated by:
• hemorrhage
• infection
• perforation (piercing) of an organ or tissue
Laser surgery can also involve risks that are not associated with traditional surgical procedures. Being careless or not practicing safe surgical techniques can severely burn the patient’s lungs or even cause them to explode. Patients must wear protective eye shields while undergoing laser surgery on any part of the face near the eyes or eyelids, and the United States Food and Drug Administration has said that both doctors and patients must use special wavelength-specific, protective eyewear whenever a CO2 laser is used. There are other kinds of dangers that laser surgery can impose of which the patient should be aware. Laser beams have the capacity to do a great deal of damage when coupled with high enough energy and absorption. They can ignite clothing, paper, and hair. Further, the risk of fire from lasers increases in the presence of oxygen. Hair should be protected and clothing should be tied back, or removed, within the treatment areas. It is important to guard against electric shock, as lasers require the use of high voltage. Critically, installation must ensure proper wiring.
Laser beams can burn or destroy healthy tissue, cause injuries that are painful and sometimes permanent, and actually compound problems they are supposed to solve. Errors or inaccuracies in laser surgery can worsen a patient’s vision, for example, and lasers can scar and even change the skin color of some patients. All of the above risks, precautions, and potential complications should be discussed by the doctor with the patient.
Normal results
The nature and severity of the problem, the skill of the surgeon performing the procedure, and the patient’s general health and realistic expectations are among the factors that influence the outcome of laser surgery. Successful procedures can enable patients to feel better, look younger, and enjoy longer, fuller, more active lives. A patient who is considering any kind of laser surgery should ask the doctor to provide detailed information about what the outcome of the surgery is expected to be, what the recovery process will involve, and how long it will probably be before a normal appearance is regained and the patient can resume normal activities.
A person who is considering any type of laser surgery should ask the doctor to provide specific and detailed information about what could go wrong during the procedure and what the negative impact on the patient’s health or appearance might be.
Lighter or darker skin may appear, for example, when a laser is used to remove sun damage or age spots from an olive- or dark-skinned individual. This abnormal pigmentation may or may not disappear over time.
Scarring or rupturing of the cornea is uncommon, but laser surgery on one or both eyes can:
• increase sensitivity to light or glare
• reduce night vision
• permanently cloud vision, or cause sharpness of vision to decline throughout the day
Signs of infection following laser surgery include:
• burning
• crusting of the skin
• itching
• pain
• scarring
• severe redness
• swelling
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