Sorry for the delay to your SLTI question, but I was on a fishing quest down Mexico way.
Many surgeons are using their equipment, here is some info from the SLTI web-site>http://www.slti.com/morganstern.html
slti.com
I suggest you read them carefully, this technology is for real, and I know a few people who had prostate surgery over the last 15 months, the old way, and they still have problems, like leakage, amongst other things.
It is not a cake walk like they make you think it is.
This is serious stuff, and SLTI offers better, more precise options.
"Prostate Laser Surgery
(to relieve urinary outflow obstruction)
Traditional electrosurgical Transurethral Resection of the Prostate (TURP) has been widely utilized and has remained relatively unchanged for 50 years, despite the fact that it is associated with post-op bleeding, morbidity, hospital stay and high costs. Recent advances in the use of lasers for urinary outflow obstructions are now being widely reported as providing significant benefits to the patient.
Surgeons have explored the use of "free-beam" Nd:YAG laser energy to relieve urinary outflow obstruction while eliminating the drawbacks of electrosurgical TURP. While the urodynamic results have been generally positive and the control of bleeding is excellent, this technique has two major disadvantages: 1) it relies on progressive symptom improvement over 6-12 weeks, and 2) it requires a post-operative catheter for a week or more.
To eliminate these disadvantages in an otherwise attractive procedure, urologists such as Dr. Steven Morganstern, Atlanta, GA; Dr. Edward Mueller, San Antonio, TX and Dr. Inder Perkash, Palo Alto, CA have utilized the SLT Contact Laser to perform transurethral prostatectomy. The results have been extremely favorable for the patient. Patients are generally sent home without a catheter within 24 hours of surgery and are voiding successfully. Dr. Mueller's patients are typically allowed full, unrestricted activity within 24 hours of discharge (i.e. generally within 48 hours of surgery). Symptom improvements after SLT Contact Laser Prostatectomy have been excellent."
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They also have technology to make surgery easier for the ladies.
"Hysterectomy
Hysterectomy is one of the most commonly performed surgical procedure in the United States. Recent advances in available surgical device technologies have enabled gynecologists to perform hysterectomies less invasively, in a procedure called laparoscopically assisted vaginal hysterectomy (LAVH). While this procedure offers numerous benefits to the patient, it provides some new challenges to the surgeon.
The surgeon is assisted in overcoming these challenges with advanced instrumentation. One such device, the SLT Contact Laser, offers the gynecologist unparalleled precision, hemostasis and control during laparoscopic surgery, and has become extremely useful for a variety of advanced gynecologic laparoscopic surgeries, including LAVH."
Clinical review>
slti.com
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Contact Laser Mastectomy
The Procedure
In performing Contact Laser Mastectomy, only one surgical tool is needed to perform the entire procedure from start to finish. Dr. Maker and Dr. Snyder have found the Contact Laser Scalpel in conjunction with SLT's CL60 Nd:YAG Laser provides excellent precision, coagulation and speed in all phases of the procedure.
Some surgeons may prefer to use the familiar scalpel technique to make the initial skin incision. This step, however, can be performed rather simply and with little or no bleeding using a Contact Laser Scalpel. Although the Contact Laser Scalpel can create a 400 micron zone of tissue damage in skin, Dr. Maker has found that he can control the tissue damage placement by manipulating the Contact Laser Scalpel's orientation toward the tissue that will be ultimately removed. The remaining healthy skin shows little if any tissue damage and excellent post-operative healing is observed.
In raising skin flaps, the conventional method of scalpel and electrocautery presents a dilemma. Use of the scalpel produces bleeding and risks contamination of healthy tissue. Cancer cells can be unknowingly dissected via the scalpel and subsequently spread, contributing to local recurrence. The heat and sterilization effect of electrocautery mitigates these problems, but generates others. Electrocautery stimulates nerves, therefore making surgical precision and control extremely difficult. The Contact Laser technique combines the advantages of both the scalpel and electrocautery by producing a precise flap in a bloodless field with no
electrical stimulation or charring. Anatomic visualization is excellent and, in the process, the Contact Laser Scalpel seals off nerve endings. Dr. Maker and Dr. Snyder both believe this element contributes to the conspicuous absence of pain experienced by patients post-operatively.
The advantages of the Contact Laser technique are particularly evident during the axillary dissection where meticulous precision is critical. Dissection of the axillary vein is extremely difficult to perform using electrocautery without risking tissue damage to contiguous structures. The hundreds of nerves in this region create uncontrollable tissue spasm when electrocautery is employed. The conventional process using scissors, scalpel, hemostats and sutures, is not only time consuming but leaves the surgeon overly dependent upon the skill of his assistant. Hemostats damaging tissue and sutures remaining in the body, can impair recovery time.
In a Contact Laser Mastectomy, the surgeon dissects lymph nodes from vessels and nerves while traction and counter traction are applied. The axillary vein is freed from surrounding tissue with precision, hemostatic control, no tissue stimulation and less assistance. Lymphatics and nerves are sealed. Dr. Snyder's pathology reports have indicated that more lymph nodes are removed using a Contact Laser Scalpel, indicating a more thorough dissection.
In removing the breast tissue from the pectoralis major and minor muscles, Dr. Maker has been able to make a clean dissection, leaving the muscle tissue absolutely untouched. By directing the Contact Laser Scalpel toward the breast tissue being removed, he produces no muscle tissue damage, whatsoever. Small vessels are coagulated prior to the transection, precipitating a fast muscle dissection. Larger vessels, up to 2mm, are coapted with the side of the Contact Laser Scalpel.
Nerve and muscle stimulation is particularly critical in this phase of the surgery. Electrocautery causes tremendous stimulation and contributes to muscle soreness post-operatively. The Contact Laser Scalpel produces no muscle or nerve stimulation. Dr. Maker and Dr. Snyder both believe that this lack of muscle stimulation has contributed to the excellent post-operative results they have seen.
Post-Operative Results and Implications
The collective experience of these two surgeons indicates that a Contact Laser Mastectomy provides the control and familiarity of a hand-held instrument, but with distinctive advantages over conventional surgical techniques. The precision of the Contact Laser Scalpel produces excellent control of surgical margins and safe dissection of the axillary vein. The hemostatic capability assures clear anatomic visualization, fewer ligations and reduced dependency on surgical assistance. Overall blood loss and drainage both appear to be equivalent to that found in the conventional scalpel /electrocautery method. The time of the procedure is equivalent to the conventional approach, as well, but only after technical proficiency is developed.
Post-operatively, the typical hospital stay is reduced by 1-3 days. Patients become fully functional more quickly with better mobility, and experience a marked decrease in pain and medication usage. 50% of the patients require two Tylenol or less, total dosage, post-operatively. The overall cost savings of such improvements are in excess of $1,000 per patient, or an aggregate economic savings of greater than $132 million annually.
Dr. Maker and Dr. Snyder express great satisfaction with Contact Laser Mastectomy and with the positive affect it has had on their patients and on their overall practice. Both surgeons have experienced a significant increase in mastectomy cases due to word-of-mouth referrals and an overwhelming response among women in their community to the benefits of this new technique.
Plus spinal/neurosurgery and more. |
