Alexei Baranov. Photo: goslasmed.ru
The unique properties of laser radiation are widely used in all areas of medicine, however, is still not accounted for in the MMI system. About the peculiarities of laser medicine, its benefits and the problems told to “Mednovosti” Director of the State scientific center of laser medicine FMBA of Russia Alexei Baranov.
What is a laser and how does it work?
A laser is an optical quantum generator, is the source of very narrow and powerful beam of light. Simply put, laser treatment is phototherapy. Literally, the acronym LASER (light amplification by stimulated emission of radiation) means “light amplification by stimulated emission of radiation”.
Light medical laser is chosen strictly defined wavelength, as every cell in the human body responds to their wavelength. Therefore, affecting the entire body, each laser has its predominant point of application.
There are two types of medical lasers: low-intensity (physiotherapy) and high (surgical scalpels). Patients sometimes are afraid of the term “radiation”, which they associate with radiation and radiation. But to confuse these concepts should not be.
Where used medical laser?
The laser is used today in all fields of medicine. Low-intensity lasers used for photodynamic therapy (PDT) and laser therapy. In addition to Oncology, PDT is used in gastroenterology and dermatology, for example, in the treatment of psoriasis.
The laser is indispensable in purulent surgery – it sterilizes wounds, promotes healing of burns and festering wounds soft and supple scar. In the Soviet Union by order of the USSR Ministry of health laser technology has been equipped with all the burn centers.
The laser helps with frequent nasal bleeding and chronic tonsillitis, you can treat snoring. Urologists laser crushed stones in the ureter that relieves the patient it is a complex operation. With minimal “jewelry” of the laser exposure can be carefully removed, for example, papilloma between the lashes without damaging surrounding tissue. The removal of tattoos, moles, resurfacing of scars is that the laser allows you to do neat and beautiful. Therefore, it is widely used in cosmetics, which is very important to the aesthetic effect.
Laser scalpel – a tool in the hands of an experienced surgeon. Operation with its practical use are bloodless. The laser cuts through the tissue and stimulates healing, what it can not do any other scalpel. The wounds themselves remain sterile, and this minimizes the development of inflammation.
Using a surgical laser can radically cure the ingrown nail, and it is possible to conduct complex operations like resection of the stomach or intestine. Using it you can remove the meniscus, treat varicose veins, spending endovasal laser obliteration of varicose veins, instead of the traditional phlebectomy. Rough scars and scars after surgery, remains.
When laser treatment is contraindicated?
Absolute contraindication is a photodermatosis – skin sensitivity to light (sun Allergy), hypersensitivity to laser light, and extremely serious condition of the patient (for chronic diseases or acute infections). The rest of laser therapy when applied correctly has almost no contraindications.
The methodical recommendations of the Ministry of health as contraindications are high blood pressure, heart attacks. While cardiologists prescribe effective therapy to reduce the lesions. Used for rehabilitation after stroke intravenous laser irradiation of low intensity improves blood flow, promoting more efficient recovery. However this technique has not every neurologist, and one that is a specialist in laser medicine. In Pediatrics, the laser is performed to children from the age of two weeks.
To the General contraindications to the use of laser treatment is the cancer, however, doctors successfully treated with laser some forms of cancer (e.g., tumors of the oral cavity).
What are the complications caused by laser treatment?
Complications voznikajut wrong use of the laser. So, illiterate use of surgical laser can even cause burns of 4 degrees. The main role when using such a powerful tool is played by the competence of the doctor.
It is necessary to consider that the laser improves blood circulation and reduces blood viscosity, which may cause bleeding. For example, the nasal-induced increase in pressure. The laser increases blood flow in the tissues, that locally describes the capillaries. Active vessels are dilated within 6 hours after the procedure. This means that all this time people must be warm to prevent hypothermia.
How laser technology is used in diagnosis?
Fluorescent diagnostics allows to detect the pathological lesions that are often impossible to detect in other ways. So, endoscopic examination of the gastrointestinal tract lighting in different color helps to see the polyps. For the diagnosis of tumors of widely used optical coherence tomography, in which laser beam probes the tissue and the reflected signal shows the structure of the tumor. The results of this method of 95% corresponds to the results of histological examination. The method of laser Doppler flowmetry is used to study the microcirculation in the tissues, e.g., blood flow in diabetes.
What are the prospects for the development of laser medicine in Russia?
Any scientific developments require funding and clinical base. Today, the funding, unfortunately, is reduced. And do the laser treatments are not included in the standards of OMS, that is, in the mandatory list of free medical procedures. Because of this, not only patients but also physicians are not familiar with the techniques of laser treatment.
The patient can either be treated for their money or waiting long queues in those places where there is an agreement of the leadership of the clinic with the insurance company about paying for treatment. However, due to its high efficiency expensive services are popular, and throughout the country offers many commercial centers.
That can be taken for the evaluation criteria of such a centre? How to avoid mistakes when choosing?
A good laser clinic is a first, modern equipment. (By the way, the domestic laser medical equipment is quite competitive, the only problem is the “lame” design, but he in recent years has improved). Second, the doctors completed advanced training in the specialty “Specialist in laser medicine” at the national centre, which conducts research and development and developed the applied methodology. Fsbi “State scientific center of laser medicine FMBA of Russia” determined by the Ministry of health as the lead Agency in the state structure, responsible for training.
Is it possible to use a laser medical devices in the home?
Medical laser devices can be used at home. Actively can use the laser at home, for example, people whose profession is connected with high physical activity – athletes, astronauts, specialists of MES. Available portable laser devices quite a lot. However, their independent application requires mandatory consultation with a specialist. One study of the user there is still not enough.
On the application of laser technology in cosmetology, see the second part of the conversation with Alexey Baranov in a week.