Laser Application in Biomedical Engineering
1. Fundamental Principle of Laser
Acronym: Light Amplification by Stimulated Emission of Radiation.
Core Principle: A laser generates a beam of coherent, monochromatic (single wavelength),
and collimated (parallel, minimally diverging) light.
Key Components:
1. Active Medium: Can be a solid (Ruby, Nd:YAG), liquid (Dye), or gas (CO₂, Argon, Excimer). It determines the
wavelength.
2. Energy Source (Pumping Mechanism): Excites the atoms in the active medium to a higher energy level
(optical flash lamp, electrical discharge).
3. Optical Cavity: Two mirrors (one fully reflective, one partially reflective) at opposite ends of the active
medium. Light bounces back and forth, stimulating emission and amplifying the light. The partially reflective
mirror lets the coherent beam escape.
2. Laser-Tissue Interaction (How it Works)
The biological effect depends on the laser's wavelength, power, pulse duration, and the tissue
properties (water content, pigmentation).
Photothermal Effect: Most common surgical effect. Light energy is converted to heat.
o Vaporization: >100°C. Tissue is ablated or cut (e.g., CO₂ laser).
o Coagulation: 60-100°C. Proteins denature, blood vessels seal (e.g., Nd:YAG laser).
o Hyperthermia: 42-45°C. Weakening or killing cells (e.g., cancer therapy).
Photochemical Effect: Light drives a chemical reaction.
o Photodynamic Therapy (PDT): A photosensitizing drug is injected and absorbed by target cells (e.g.,
cancer). Laser light of a specific wavelength activates the drug, producing a toxic form of oxygen that kills the
cells.
Photoablation: High-energy pulsed UV lasers (Excimer) break molecular bonds directly, "coldly" etching
away tissue with minimal thermal damage (e.g., LASIK eye surgery).
Photodisruption: Very high-power, short-pulsed lasers (Nd:YAG) create an optical breakdown and plasma
spark, generating a shockwave that mechanically fragments tissue (e.g., breaking up kidney stones).
3. Common Medical Lasers & Their Applications
Laser Wavele Active
Key Properties Primary Medical Applications
Type ngth Medium
CO₂ 10.6 Gas (Carbon Strongly - Dermatology: Wart removal,
μm Dioxide) absorbed by skin resurfacing.
water. Excellent - General Surgery: Cutting,
Laser Wavele Active
Key Properties Primary Medical Applications
Type ngth Medium
for precise cutting
and vaporization excision (e.g., laryngeal tumors).
with shallow - Gynecology.
penetration.
Solid Poorly absorbed - Urology: Prostate resection,
(Neodymium by water, deeply lithotripsy.
1064 -doped scattered. Excelle - GI: Coagulating bleeding ulcers.
Nd:YAG
nm Yttrium nt for coagulation - Oncology: Tumor ablation.
Aluminium and deep thermal - Ophthalmology: Posterior eye
Garnet) therapy. procedures.
- Ophthalmology: Photocoagula
Well absorbed tion for diabetic retinopathy.
488/51
Argon Gas (Argon) by hemoglobin - Dermatology: Treating
4 nm
and melanin. vascular lesions (port-wine
stains).
UV, high photon
- Ophthalmology: LASIK and
Gas (e.g., energy. Causes
193 nm PRK for vision correction.
Excimer Argon photoablation
(ArF) - Angioplasty: Removing
Fluoride) with minimal
arterial plaque.
thermal damage.
- Dermatology: Hair removal,
Compact,
800- Semiconduct vascular lesions.
Diode efficient,
980 nm or - Dentistry: Soft tissue surgery.
portable.
- PDT.
4. Delivery Systems
Articulated Arms: A series of mirrors for CO₂ lasers (as its wavelength doesn't travel through fibers).
Optical Fibers: Flexible fibers used for Nd:YAG, Argon, Diode lasers for endoscopic and laparoscopic
applications.
Waveguides: Hollow, flexible tubes for delivering CO₂ laser energy without an articulated arm.
5. Laser Safety in Medicine (CRITICAL)
Hazards:
o Eye Damage: Retinal burn (visible & near-IR lasers) or corneal burn (CO₂ laser). Everyone in the room
must wear wavelength-specific safety goggles.
o Skin Burns: From direct or scattered beam.
o Fire Hazard: Ignition of drapes, endotracheal tubes. Use fire-resistant materials and have a fire
extinguisher ready.
o Electrical Hazard: High-voltage power supplies inside the laser.
o Plume (Smoke Plume): The vaporized tissue can contain viable viruses (e.g., HPV) and toxic chemicals. Use
a smoke evacuator with a high-efficiency particulate air (HEPA) filter.
Safety Standards (IEC 60825-1): Classifies lasers based on their hazard potential. Most medical lasers
are Class 4 (high power, can cause fire and serious skin/eye damage).
Control Measures:
o Interlocks: On doors to prevent operation if the room is entered.
o Key Switch: Prevents unauthorized use.
o Training: Mandatory for all users.
o Laser Safety Officer (LSO): Appointed to oversee safety protocols.
Expected Exam Questions (MCQs)
1. The property of laser light that allows it to be focused to a very small spot is its:
a) Brightness
b) Collimation (being parallel)
c) Monochromaticity
d) Coherence
2. Which laser is most absorbed by water and is therefore excellent for precise superficial cutting?
a) Nd:YAG laser
b) CO₂ laser
c) Argon laser
d) Diode laser
3. Photodynamic Therapy (PDT) is primarily a ________ effect.
a) Photothermal
b) Photochemical
c) Photoablative
d) Photodisruptive
4. The laser most commonly used for coagulating bleeding ulcers during endoscopy is the:
a) CO₂ laser
b) Nd:YAG laser
c) Excimer laser
d) Argon laser
5. The primary hazard associated with the tissue plume generated during laser surgery is:
a) Electrical shock
b) Inhalation of toxic chemicals and viable pathogens
c) Fire
d) Eye strain
6. Which laser uses a flexible optical fiber for delivery?
a) CO₂ laser
b) Diode laser
c) Both a and b
d) None of the above
7. The mechanism of action of an Excimer laser in LASIK surgery is:
a) Vaporization
b) Coagulation
c) Photoablation (breaking molecular bonds)
d) Photodisruption
8. The most important safety precaution for anyone in a room where a Class 4 laser is in use is to
wear:
a) A lead apron
b) Wavelength-specific laser safety goggles
c) Sterile gloves
d) A face mask
9. A laser is characterized by all of the following properties EXCEPT:
a) Coherence
b) Monochromaticity
c) Divergence
d) Collimation
10. The Nd:YAG laser is particularly effective in urology for:
a) Tattoo removal
b) Fragmenting kidney stones (lithotripsy)
c) Skin resurfacing
d) Vision correction
