Laser Surgery In Veterinary Medicine:
Wave of the Future or High-Tech Hype?

By Mark C. Brown, DVM, CCRP

You may have noticed recently that some veterinary hospitals around the country are promoting the use of lasers in their practices.  These practices also claim that the use of lasers in soft tissue surgery is the “new medicine—a pain-free, superior standard” in soft tissue surgery.  At Central Animal Hospital, we have researched lasers and their place in veterinary medicine and have realized some interesting facts (outlined below) as well as another option called radiosurgery which has been proven to be a better choice for soft tissue surgery. 

Facts about Lasers Used for Soft Tissue Surgery

• Laser surgery is light focused on an area of soft tissue which causes vaporization of the cells in the path of the light beam.  This beam of light can be compared to a flashlight with a beam of light emitting out into infinity.
• Laser surgery causes considerably more tissue necrosis (dying cells) than cold steel (a scalpel) or radiosurgery.
• Laser light can cause eye damage in some cases if aimed into the eyes.
• Laser surgery produces a large plume (smoke) which may carry disease particles. Laser light, a beam of light, can be difficult to control where it travels.
• Lasers have largely been abandoned by the human medical profession due to lack of precise control and the fact that there are better surgical options.*

What is Radiosurgery* and How Does It Compare to Laser Surgery?

• Radiosurgery is the gold standard for soft tissue surgery in the human medical field where precise skin and/or soft tissue incisions are required (such as plastic surgery). 
• Radiosurgery is also the standard for general soft tissue surgery where minimal tissue damage and almost no postoperative pain is desired.
• Radiosurgery is the surgical method used at Central Animal Hospital.

After  using lasers for the latter part of the 1970’s and early 1980’s, most human medicine soft tissue surgeons and plastic surgeons have returned to radiosurgery.  Since this caused a reduction in the sale of lasers in the human medical field, the laser industry has focused on the veterinary community to sell their wares.  Some veterinarians have swallowed the bait—hook, line and sinker without fully researching lasers.  They have purchased expensive Co2 lasers after being told half-truths about the “star wars” effects these machines produce.

The real truth is that the standard scalpel blade causes the least amount of tissue margin damage, but in so doing, it also leaves open nerve endings which cause marked postoperative pain.  The scalpel is also difficult to use in delicate skin tissue around the eye, lips, anus, prepuce, etc. due to the skin’s elasticity.

Only radiosurgery comes close to the scalpel in minimal tissue trauma and necrosis.  The laser places a distant third in comparison.  The actual cutting effect of radiosurgery occurs with the use of radio waves emitted from the small wire tip at the end of the surgical wand.   Highly controlled and finely tuned radio waves emit from the wire to the antenna which is in the vicinity of the surgical field.

Radiosurgery is sometimes referred to as radiocautery (not to be confused with electrocautery where electricity is the energy source).  However, the proper description is radiosurgery.  The radio waves excite the water molecules in the desired tissue cells as the radiosurgical wire is pulled through the tissue, causing these cells to vaporize.  It is a more precise method than even the best lasers when used in soft tissue surgery.  Lasers, however, are very precise when connected to a computer for surgery like human LASIK surgery of the eye, but typically not when used in the hand of a surgeon.  One striking feature that radiosurgery and laser surgery share is that they both seal the neurovascular (nerve, venule and arteriole) bundles which result in almost pain-free post-operative recovery.

(Dr. Brown is Owner & Chief of Staff at Central Animal Hospital on Pinellas Point and Central Animal Hospital & Tampa Bay K9 Rehabilitation Center on 4th Street North in St. Petersburg.)

Additional information can be found on www.centralanimal.net