A surgical carbon dioxide laser is disclosed which includes a handpiece for directing a laser beam to a desired location. Mounted on the forward end of the handpiece is a hollow needle precisely aligned along the laser path. This permits the laser to be used in surgical applications where the needle perforates a porton of tissue to provide the laser beam direct access to distal tissue. The needle is mounted to the handpiece in a manner which provides for forward and lateral adjustment of the needle relative to the laser beam path which insures co-axiality between the laser beam and the needle lumen. This is crucial for the safe use of the laser. The needle is adjusted such that the focal point of the laser beam is approximately at the tip of the needle. This provides maximum energy at the tip of the needle where it is required. This apparatus is particularly useful in transmyocardial devices utilized to provide ischemic endocardial tissue direct access to blood within the ventricular cavity. The device is inserted within the epicardium of the heart; the laser is then activated to vaporize a channel of tissue through the endocardium. This provides for perforation of the endocardium with minimal damage to the epicardium.

Method and apparatus for transmyocardial revascularization using a laser

This paper reports the experience of three general surgeons performing 304 laparoscopic cholecystectomies in three private hospitals between October 1989 and November 1990. Laparoscopic cholecystectomy boasts two major advantages over the conventional procedure: the remarkable reduction in postoperative pain and economic benefit, largely due to the patient's early return to work. Revealing a complication rate of 2% and no deaths, this study has shown that this procedure can offer patients these advantages with a medical risk no greater than that accompanying conventional cholecystectomy. Patient safety must be paramount, and it is the responsibility of the surgical community to ensure that all surgeons receive the highest quality training and that the technique is applied appropriately.

Appraisal of laparoscopic cholecystectomy.

Laser laparoscopy in the treatment of endometriosis. A 5-year study.

This review article has focussed on identifying the evidence from randomized controlled trials for the medical and surgical management of endometriosis. A critical summary of the medical management has shown that there is little difference in effectiveness of various medical treatments, but there are differences in the side-effect profiles. Few randomized controlled trials have been undertaken in surgery, but these have shown that surgical management is effective in the management of both painful symptoms and subfertility.

The evidence for the management of endometriosis

Laparoscopic salpingostomy utilizing the CO2 laser

Carbon dioxide laser laparoscopy: initial experience in experimental animals and humans.

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Carbon dioxide laser laparoscopy: initial experience in experimental animals and humans.