Combined CO2-Nd:YAG Radiation in Liver and Anorectal Diseases

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Abstract
A 1986 report of the authors' experience in human liver surgery emphasized the promise of a combined delivery of CO 2 and Nd:YAG wavelengths, using an artificial procedure of linking two separate handpieces. A newer machine is available now which emits simultaneous CO 2 and Nd:YAG radiations in a single, coherent, coaxial beam (Combolaser, Lasermatic). This study compares the effects of the combined coaxial delivery in such fields as benign proctology, vaporizations of anorectal and liver tumors, and laser liver resections, where clinical experience with wavelengths used separately or successively have been reported. Between September 1989 and October 1991, 104 patients have had such operations. The results demonstrate a reduction of energy densities when combined delivery is compared with single laser irradiation for the same purpose. The necrotic zone is reduced with better hemostasis. Finally, a significant reduction of operative time for tumoral vaporizations has been noted. In conclusion, the combined beam modifies the laser-tissue interaction, and allows the surgeon to work with suitable power ratios, according to the tissues' stroma, and vascularity.