laser medicine

In 1916, Albert Einstein established the theoretical foundations for the laser and the maser in the paper "Zur Quantentheorie der Strahlung" ("On the Quantum Theory of Radiation"), conceptually based upon probability coefficients (Einstein coefficients) for the absorption, spontaneous emission, and stimulated emission of electromagnetic radiation.

Lasers benefit from three interesting characteristics: directivity (multiple directional functions), impulse (possibility of operating in very short pulses), and monochromaticity.{{cite web | url=https://www.techniques-ingenieur.fr/base-documentaire/biomedical-pharma-th15/electronique-robotique-et-tic-pour-la-sante-42628210/lasers-en-medecine-med1500/ | title=Lasers en médecine }}

Several medical applications were found for this new instrument. In 1961, just one year after the laser was put it practical use, Dr. Charles J. Campbell successfully used a ruby laser to destroy an angiomatous retinal tumor with a single pulse.{{Cite web |title=It Happened Here: The Ruby Laser |url=https://healthmatters.nyp.org/ruby-laser/ |access-date=April 24, 2023 |website=NewYork-Presbyterian|date=30 March 2017 }} In 1963, Dr. Leon Goldman used the ruby laser to treat pigmented skin cells and reported on his findings.{{Cite journal |last=Appold |first=Karen |date=April 11, 2019 |title=The history of aesthetic lasers |url=https://www.dermatologytimes.com/view/history-aesthetic-lasers |access-date=April 24, 2023 |website=Dermatology Times|series=Dermatology Times, April 2019 (Vol. 40, No. 4) |volume=40 }}

The argon-ionized laser (wavelength: 488–514 nm) has since become the preferred laser for the treatment of retinal detachment. The carbon dioxide laser was developed by Kumar Patel and others in the early 1960s and is now a common and versatile tool not only for medicinal purposes but also for welding and drilling, among other uses.{{Cite web |title=C. Kumar N. Patel |url=https://www.invent.org/inductees/c-kumar-n-patel |access-date=April 25, 2023 |website=Invent.org}}

The possibility of using optical fiber (over a short distance in the operating room) since 1970 has opened many laser applications, in particular endocavitary, thanks to the possibility of introducing the fiber into the channel of an endoscope.

During this time, the argon laser began to be used in gastroenterology and pneumology. Dr. Peter Kiefhaber was the first to "successfully perform endoscopic argon laser photocoagulation for gastrointestinal bleeding in humans". Kiefhaber is also considered a pioneer in using the Nd:YAG laser in medicine, also using it to control gastrointestinal bleeding.{{Cite journal |last1=Khemasuwan |first1=Danai |last2=Mehta |first2=Atul C. |last3=Wang |first3=Ko-Pen |date=December 2015 |title=Past, present, and future of endobronchial laser photoresection |journal=Journal of Thoracic Disease |volume=7 |issue=4 |pages=S380–S388 |doi=10.3978/j.issn.2072-1439.2015.12.55 |pmid=26807285 |pmc=4700383 }}

In 1976, Dr. Hofstetter employed lasers for the first time in urology. The late 1970s saw the rise of photodynamic therapy, thanks to laser dye. (Dougherty, 1972{{Cite web |author=Serge Mordon |date=10 October 2013 |title=Différents effets des lasers médicaux |website=Techniques de L'ingenieur |url=https://www.techniques-ingenieur.fr/base-documentaire/biomedical-pharma-th15/imagerie-medicale-therapies-par-ondes-42607210/lasers-en-medecine-med1500/differents-effets-des-lasers-medicaux-med1500niv10001.html |url-access=subscription |language=fr}})

Since the early 1980s, applications have particularly developed, and lasers have become indispensable tools in ophthalmology, gastroenterology, and facial and aesthetic surgery.

In 1981, Goldman and Dr. Ellet Drake, along with others, founded the American Society for Laser Medicine and Surgery to mark the specialization of certain branches of medicine thanks to the laser.{{Cite web |title=ASLMS History |url=https://www.aslms.org/about-aslms/history |access-date=April 24, 2023 |website=American Society for Laser Medicine and Surgery}} In the same year, the Francophone Society of Medical Lasers (in French, Société Francophone des Lasers Médicaux) was founded for the same purpose and was first led by Maurice Bruhat.{{Cite web |title=About SFPMed |url=https://sfpmed.org/en/ |access-date=April 24, 2023 |website=SFPMed}}

After the end of the 20th century, a number of centers dedicated to laser medicine opened, first in the OCDE, and then more generally since the beginning of the 21st century.

The Lindbergh Operation was a historic surgical operation between surgeons in New York (United States) and doctors and a patient in Strasbourg (France) in 2001. Among other things, they utilized lasers.

The laser presents multiple unique advantages that make it very popular among various practitioners.

• Due to its directional precision, a laser precisely cuts and cauterizes tissues without damaging neighboring cells. It's the safest technique and most precise cutting and cauterizing ever practiced in medicine.
• Laboratories use lasers extensively, especially for spectroscopy analysis and more generally for the analysis of biochemical samples. It makes it possible to literally "see" and more quickly determine the composition of a cell or sample on a microscopic scale.
• The electrical intensity of a laser is easily controllable in a safe way for the patient but also variable at will, which gives it a very wide and still partially explored range of uses (in 2021).

The principal disadvantage is not medical but rather economic: its cost. Although its price has dropped significantly in developed countries since its inception, it remains more expensive than most other common technical means due to materials, the technicality of the equipment necessary for the operation of any laser therapy, and the fact that it requires only certain specific training.

For example, in France (as in other countries with a social security system), dental, endodontal or periodontal laser treatment is classified outside the nomenclature and not reimbursed by social security.

Lasers used in medicine include, in principle, any type of laser, but especially the following:

• CO₂ lasers,{{cite journal|last=Polanyi|first=T.G.|title=A CO₂ Laser for Surgical Research|journal=Medical & Biological Engineering|volume=8|year=1970|issue=6|pages=541–548|doi=10.1007/bf02478228|pmid=5509040|s2cid=40078928}} used to cut, vaporize, ablate, and photocoagulate soft tissue.{{Cite web|url=https://lightscalpel.com/laser-surgery/|title=Soft-Tissue Laser Surgery - CO2 Surgical Laser - LightScalpel|website=LightScalpel|language=en-US|access-date=2016-04-04}}
• diode lasers{{cite journal|last=Loevschall|first=Henrik|title=Effect of low-level diode laser irradiation of human oral mucosa fibroblasts in vitro|journal=Lasers in Surgery and Medicine|volume=14|issue=4|year=1994|pages=347–354|doi=10.1002/lsm.1900140407|pmid=8078384|s2cid=11569698}}
• dye lasers{{cite book |editor = Duarte FJ|title=Tunable Laser Applications | edition = 3rd |publisher= CRC Press |location=Boca Raton |year=2016 |isbn=9781482261066 |vauthors=Costela A, Garcia-Moreno I, Gomez C | chapter = Medical Applications of Organic Dye Lasers| pages = 293–313 }}
• excimer lasers
• fiber lasers{{cite book |editor =Duarte FJ |title=Tunable Laser Applications | edition = 3rd |publisher= CRC Press |location=Boca Raton |year=2016 |isbn=9781482261066 | author = Popov S | chapter = Fiber Laser Overview and Medical Applications | pages = 263–292 }}
• gas lasers
• free electron lasers
• semiconductor diode lasers{{cite book |editor = Duarte FJ |title=Tunable Laser Applications | edition = 3rd |publisher= CRC Press |location=Boca Raton |year=2016 |isbn=9781482261066 | author = Duarte FJ | chapter = Broadly Tunable External-Cavity Semiconductor Lasers| pages = 203–241 }}

Examples of procedures, practices, devices, and specialties where lasers are utilized include the following:

• angioplasty
• cancer diagnosis{{Citation|last=Duarte|first=Francisco Javier|title=Two-laser therapy and diagnosis device, EP0284330A1 |date=Sep 28, 1988|url=https://patents.google.com/patent/EP0284330A1|access-date=2016-04-18}}
• cancer treatment{{cite book |editor1= Duarte FJ |editor2=Hillman LM |title=Dye Laser Principles |publisher= Academic Press |location=Boston |year=1990 |pages= 419–32 | chapter = Dye Lasers in Medicine |isbn=0-12-222700-X | author = Goldman L | author-link = Leon Goldman }}
• dentistry
• cosmetic dermatology such as scar revision, skin resurfacing, laser hair removal, and tattoo removal
• dermatology, to treat melanoma
• frenectomy
• gingivectomy
• lithotripsy
• laser mammography{{cite book |editor =Duarte FJ |title=Tunable Laser Applications | edition = 2nd |publisher= CRC Press |location=Boca Raton |year=2008 |isbn=978-1-4200-6009-6 | author = Carroll FE | chapter = Pulsed, Tunable, Monochromatic X-rays: Medical and Non-Medical Applications | pages = [https://books.google.com/books?id=FCDPZ7e0PEgC&pg=PA281 281–310] }}
• medical imaging
• microscopy{{cite book |editor =Duarte FJ |title=Tunable Laser Applications | edition = 3rd |publisher= CRC Press |location=Boca Raton |year=2016 |isbn=9781482261066 |author1=Orr BJ |author-link=Brian Orr |author2=Haub J G |author3=He Y |author4=White RT | chapter = Spectroscopic Applications of Pulsed Tunable Optical Parametric Oscillators | pages = 17–142 }}{{cite book |editor =Duarte FJ |title=Tunable Laser Applications | edition = 2nd |publisher= CRC Press |location=Boca Raton |year=2008 |isbn=978-1-4200-6009-6 |vauthors=Thomas JL, Rudolph W | chapter = Biological Microscopy with Ultrashort Laser Pulses | pages = [https://books.google.com/books?id=FCDPZ7e0PEgC&pg=PA245 245–80] }}
• ophthalmology (includes Lasik and laser photocoagulation)
• optical coherence tomography
• optogenetics{{cite book |editor=Duarte FJ |editor-link=F. J. Duarte |title=Organic Lasers and Organic Photonics |publisher= Institute of Physics |location=London |year=2018 |pages= 13–1 to 13–114 | chapter = Organic dyes in optogenetics |isbn=978-0-7503-1570-8 |author=Penzkofer A |author2=Hegemann P |author2-link=Peter Hegemann |author3=Kateriya S}}
• prostatectomy
• plastic surgery, in laser liposuction,{{Cite journal|title = A comparative study of internal laser-assisted and conventional liposuction: a look at the influence of drugs and major surgery on laboratory postoperative values.|date = Oct 2013|journal = Drug Design, Development and Therapy|doi = 10.2147/DDDT.S50828|pmid = 24143076 |volume=7 |pages=1195–200 |pmc=3798112 |vauthors=Przylipiak AF, Galicka E, Donejko M, Niczyporuk M, Przylipiak J | doi-access=free }} in the treatment of skin lesions (congenital and acquired), and in scar management (burns and surgical scars)
• surgery,{{cite book |editor =Jelinkova H |title=Lasers for Medical Applications: Diagnostics, Therapy, and Surgery |publisher= Woodhead |location=Oxford |year=2013 |isbn=978-0-85709-237-3

}} to cut, ablate, and cauterize tissue

• Dental laser
• Endovenous laser therapy
• Laser-assisted new attachment procedure
• Laser surgery
• Light therapy
• Low level laser therapy
• Neuromodulation
• Neurostimulation
• Photodynamic therapy
• Photomedicine

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