Table Of ContentMEDICAL APPLICATIONS OF
LASERS
MEDICAL APPLICATIONS OF
LASERS
edited by
D. R. Vij
and
K. Mahesh
Department ofP hysics
Kurukshetra University
136119 Kurukshetra
India
SPRINGER SCIENCE+BUSINESS MEDIA, LLC
Library of Congress Cataloging-in-Publication Data
Medical applications of lasers 1 edited by D. R. Vij and K. Mahesh.
p. ;cm.
Includes bibliographical references and index
ISBN 978-0-7923-7662-0 ISBN 978-1-4615-0929-5 (eBook)
DOI 10.1007/978-1-4615-0929-5
1. Lasers in medicine. 2. Lasers in surgery. 1 Vij, D. R. II Mahesh, K., 1940-
{DNLM: 1. Lasers-therapeutic use. 2. Laser Surgery. WB 480 M488 2002}
R857.L37 M435 2002
610'.28-dc21
2001050835
Copyright © 2002 by Springer Science+Business Media New York
Originally published by Kluwer Academic Publishers in 2002
Softcover reprint ofthe hardcover lst edition 2002
Ali rights reserved. No part of this publication may be reproduced, stored in a
retrieval system or transmitted in any form or by any means, mechanical, photo
copying, recording, or otherwise, without the prior written permission of the
publisher, Springer Science+Business Media, LLC.
Printed on acid-free paper.
Table of Contents
Preface IX
Contributing Authors Xl
1. Elements of Laser Emission Process 1
K. Mahesh and D.R. Vij
l.1 Introduction 1
l.2 Components of a Laser Source 2
l.3 Laser Amplification 4
1.4 Beam Divergence 4
l.5 Monochromaticity 5
l.6 Optical Coherence Length and Time 6
l.7 Interaction of Radiation with Atomic System 7
l.8 Einstien Transition Coefficients 9
l.9 Light Amplification 11
l.10 Laser Efficiency of a Medium 13
l.11 Laser Gain 14
l.12 Q-Switched Laser 15
l.13 Ruby Laser 17
l.14 Helium-Neon Laser 17
l.15 Lasers in Medicine 19
Bibliography 20
2. Laser-Tissue Interaction 21
Cameron H. G. Wright, Steven F Barrett and Ashley J Welch
2.1 Introduction 21
2.2 General Consideration of Laser-Tissue Interaction 22
2.3 Overview of Laser Propagation in Tissue 26
2.4 Models of Laser-Tissue Propagation 36
2.5 Monte Carlo Simulation of Laser-Tissue Interaction 39
2.6 Thermal and Mechanical Damage of Tissue 46
2.7 Examples of Tissue Properties 51
2.8 Summary 53
Appendix: Helpful Mathematical Relations 54
References 56
3. Laser Ophthalmology 59
Steven F Barrett, Cameron H. G. Wright and Ashley J Welch
3.1 Introduction 59
3.2 Characteristics of the Human Eye 59
3.3 Visual Refractive Errors 65
3.4 Laser Interaction with Eye Tissues 67
3.5 Laser Applications in Ophthalmology - Diagnostic 71
3.6 Laser Applications in Ophthalmology - Therapeutic 77
3.7 Laser Applications in Ophthalmology - The Future 82
References 86
4. Laser Cardiology 91
Part-A: Laser Therapy and Diagnosis 91
Shmuel Einav
4.1 Laser Therapy 91
4.2 Laser Diagnosis 107
References (part A) 111
Part-B: Some Case Studies 114
Masayoshi Okada
4.3 Transmyocardial Laser Revascularization (TMLR) 114
4.4 Laser Vasculr Anastomosis 123
4.5 Laser Angioplasty for Cardiovascular Disease 134
References (part B) 142
5. Laser Tomography 147
Dmitry A. Zimnyakovand Valery V Tuchin
5.1 Introduction 147
5.2 Diffusing Light Technologies 147
5.3 Laser Scanning Confocal Microscopy 164
5.4 Optical Coherence Tomography 171
5.5 Spatial Speckle Correlometry 181
5.6 Imaging Techniques Based on Speckle Contrast Analysis 188
References 190
6. Lasers in Urology 195
S.K Sharma and A.K Hemal
6.1 Introduction 195
6.2 Lasers in Benign Prostatic Hyperplasia 195
vi
6.3 Laser Treatment of Bladder and Urethral Tumors 204
6.4 Stricture of Urinary Tract 210
6.5 Laser Lithotripsy 215
6.6 Some Useful Laser Devices for Lithotripsy 216
6.7 Other Uses 219
References 222
7. Laser Lithotripsy 227
Tim A. Wollin and Ronald B. Moore
7.1 Introduction 227
7.2 Surgical Management of Urinary Stones 228
7.3 Laser Lithotripsy 235
7.4 Summary 249
References 249
8. Laser Dermatology 257
Geoffrey Dougherty and Terence Ryan
8.1 Introduction 257
8.2 Basic Principles and Concepts 259
8.3 Dermatological Applications of Lasers 264
References 284
9. Laser Dentistry 289
MarkolfH Niemz
9.1 Introduction 289
9.2 The Human Tooth 289
9.3 Laser Treatment of Hard Tooth Substance 292
9.4 Laser Treatment of Soft Dental Tissue 302
9.5 Lasers in Endodontics 304
9.6 Laser Treatrment of Filling Materials 304
References 306
10. Lasers in Gynaecology 309
D. Takkar and Alka Sinha
10.1 Introduction 309
10.2 Laparoscopy/Laparotomy with Lasers 311
10.3 Hysteroscopic Procedures with Laser 318
10.4 Colposcopy with Lasers 320
10.5 Assisted Reproductive Technique (ART) 321
vii
10.6 Future Trends of Lasers in Gynaecology 322
References 323
11. Laser Safety in Medicine 327
Ken Barat
11.1 Introduction 327
11.2 Classification of Laser Hazards 327
11.3 Common Wavelengths 329
11.4 Fiber Optics 330
11.5 Laser Tissue Interaction 332
11.6 Non-beam Hazards 335
11.7 Persons Under Risks 340
11.8 Laser Safety Elements 340
11.9 Duties of a Laser Safety Officer 341
11.10 Laser Safety Committee 342
11.11 Laser Safety Training 342
11.12 Authority for Laser Procedures 343
11.13 Laser Safety in Different Settings 344
11.14 Laser Safety Devices 345
11.15 Reflections 349
11.16 Alignment Aids 350
11.17 Low Power Laser Safety 350
11.18 Laser Safety Policies and Procedures 350
11.19 Laser Incidents 353
References 353
Resource Material 354
Appendix (Glossary of Terms in Lasers and Devices) 355
Subject Index 363
viii
Preface
A careful review of the literature covering various aspects of applications
of lasers in science and technology reveals that lasers are being applied very
widely throughout the entire gamut of physical medicine. After surveying the
current developments taking place in the field of medical applications of
lasers, it was considered appropriate to bring together these efforts of
international research scientists and experts into one volume.
It is with this aim that the editors have prepared this volume which brings
current research and recent developments to the attention of a wide spectrum
of readership associated with hospitals, medical institutions and universities
world wide, including also the medical instrument industry. Both teachers
and students in the medical faculties will especially find this compendium
quite useful.
This book is comprised of eleven chapters. All of the important medical
applications of lasers are featured. The editors have made every effort that
individual chapters are self-contained and written by experts. Emphasis has
been placed on straight and simple presentation of the subject matter so that
even the new entrants into the field will find the book of value.
The first chapter deals with the elements of laser emission process. In the
second chapter on laser-tissue interaction, the authors emphasize Monte Carlo
simulation of laser-tissue. Models of laser-tissue propagation are discussed
along with the thermal and mechanical damage to tissues. The remaining
chapters deal with the use of lasers in the various fields in medicine, such as
ophthalmology, cardiology, tomography, urology, lithrotripsy, dermatology,
dentistry and gynecology. The last chapter on laser safety in medicine
describes the various hazards associated with the use of lasers, and the
required safety methods and procedures.
This book represents a valuable contribution by outstanding researchers
In their individual fields. It has an international flavor inasmuch as the
contributors are drawn from the U.S.A., U.K., Germany, Canada, Japan,
India, Russia Israel and Kuwait.
It is our pleasant duty to express our gratitude to the various authors who
made this book possible by contributing respective chapters in the fields of
their expertise. We are indebted to all those authors and publishers who freely
granted permissions to reproduce their copyrighted works. The patient
encouragement of the staff at Kluwer Academic Publishers is also thankfully
acknowledged. Last but not least, we wish to express our deep appreciation to
our wives (Dr. (Mrs.) Meenakshi Vij and Dr. (Mrs.) Brijesh Kumari Gupta
respectively) for their indispensable support, encouragement, and patience
during the completion of the task of writing and editing the book.
D. R. Vij
Kurukshetra, India K. Mahesh
x
Contributing Authors
Ken Barat, Lawrence Berkeley National Laboratory, Berkeley, California,
U.S.A., E-mail: [email protected]
Steven F. Barrett, Department of Electrical Engineering, University of
Wyoming, Laramie, Wyoming, U.S.A., E-mail: [email protected]
Geoffrey Dougherty, Department of Radiologic Sciences, Kuwait·
University, Sulaibikhat 90805, KUW AlT, [email protected]
Shmuel Einav, Department of Biomedical Engineering, Tel Aviv University,
Tel Aviv 69978, ISRAEL, E-mail: [email protected]
A.K. Hemal, Department of Urology, All India Institute of Medical Sciences,
Ansari Nagar, New Delhi - 110029, INDIA, E-mail: [email protected]
K. Mahesh, Department of Physics, Kurukshetra University, Kurukshetra-
136 119, INDIA
Ronald B. Moore, Division of Urology, Department of Surgery, University
of Alberta, Edmonton, Alberta, CANADA, Fax: (780) 432-8333
E-mail: [email protected]
Markolf H. Niemz, Mannheim Biomedical Engineering Laboratories, Uni
versity of Heidelberg, Theodor-Kutzer-Ufer, 68135, Mannheim,GERMANY
E-mail: [email protected]
Masayoshi Okada, Former Director, Kobe University School of Medicine,
1-1-39-103, Sumiyoshihonmachi, Higashinada-ku, Kobe 658-0051 , JAPAN,
Fax: +81-78-856-0123
Terence Ryan, Oxford Brookes University, Oxford, U.K.
S. K. Sharma, Director, Postgraduate Institute of Medical Education and
Research, Chandigarh , INDIA, E-mail: [email protected]
