LIGHT AND MAGIC: LASER TECHNOLOGY DEVELOPMENT MAKES MANY SURGERIES INCISIONLESS

Dr. Bill Thorpe wears specials glasses during the surgery to protect his eyes from the laser.

The surgery is viewed on a video monitor by the surgeon to see what needs to be done.

The laser itself comes out of a small wand that is inserted into the knee.

Laser light might be burning a new path in surgical procedures.

Surgeons have been using lasers in operations since the late 1960s. As the use of lasers grows and the technology develops, the advantages of laser surgery are becoming blindingly clear.

Dr. Bill Thorpe, an orthopedic surgeon, is a member of a team of doctors working to advance laser surgery. He said it is possible that sometime in the future, surgeries may be performed without cutting the skin.

"We're learning that the laser has specific effects on specific tissues and no effect on other tissues. If we can find the wavelength that will go through skin without causing burning or making a hole, we can literally have incisionless surgery," Thorpe said.

Thorpe has been using lasers in a form of tissue treatment that he said was developed in Cape Girardeau four years ago. Lasers not only have the ability to cut and vaporize tissue, they can cause week bonds in tissue to strengthen.

Thorpe said body tissue is composed of collagen, a fibrous protein. When we are young, collagen molecules tend to bond closely with one another. As we age this bond weakens causing, for example, facial tissue to lose its elasticity, producing wrinkles.

Thorpe said plastic surgeons use lasers now to wipe away these wrinkles.

Thorpe specializes in surgical procedures on joints. Some injuries to joint ligament can cause collagen bonds to weaken and the ligaments to stretch. Ligaments join bones together in joints and if the ligaments are stretched, the bones will move in ways they were not meant to.

A laser procedure that Thorpe uses renews these collagen bonds. On Wednesday, Thorpe operated on a teen-age girl who had stretched the anterior cruciate ligament in one of her knees. The injury could produce pain and the joint was unstable.

In about a half-hour, Thorpe was able to renew the ligament. The operation was performed with the use of a laser on the tip of a needle. Thorpe viewed the ligament with a fiber optic camera and guided the laser by watching a television monitor.

Kathy McKinley, a laser safety officer with St. Francis Medical Center, said lasers provide for less invasion into the body during surgery, less blood loss and many times faster recovery.

Surgeons at St. Francis use lasers in any kind of operation, McKinley said. The hospital has five kinds of lasers, each with a different specialization. Some lasers are used to remove tumors without disrupting large amounts of healthy tissue.

Surgeons used to remove portions of healthy tissue surrounding cancerous tumors in an effort to contain the spread of the cancer cells. McKinley said by using lasers the tumors can be destroyed more efficiently and samples of the surrounding tissue are examined instead of arbitrarily removed.

Nancy Stricker, clinical coordinator for St. Francis's operating rooms, said lasers are also more maneuverable than scalpels and can vaporize tumors near the spinal cord and in the brain.

The intensity of the laser beam can be adjusted to perform different tasks. When surgeons destroy a tumor they set the laser to a high-intensity beam that vaporizes the material. On a lower setting, the laser beam promotes healing within the healthy tissue by encouraging blood coagulation.

Dr. David Westrich, an eye surgeon, can adjust the color of the laser beam he uses in retinal surgery. He said if he is trying to penetrate the beam through blood he will set the color of the laser to red. Blood is seen as red because it does not absorb that spectrum of light; it reflects it.

A red beam will pass through blood but will not pass through tissue of another color. That tissue will be affected by the laser according to the intensity of the beam, it could be vaporized or simply heated.

Lasers have revolutionized Westrich's profession. Lasers are being used to change the curvature of the cornea to correct nearsightedness and eliminate the need for eye glasses. Westrich uses a laser to treat macular degeneration, eye problems associated with diabetes, blood accumulation and detached retinas.

Many of the operations he performs are done in his office and without ever making an incision.

"The laser we use in our office applies heat to tissue and either transforms it or destroys it," Westrich said. "It penetrates through all the clear structures until it gets to an opaque surface that will absorb the energy.

"It's just like light going through the window of your house. It will go through the house until it hits something and then it warms that surface."