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The Pilot Diode Laser in Veterinary Medicine
What is a Laser?
LightAmplification by
StimulatedEmission of Radiationhttp://spaceplace.nasa.gov/en/kids/laser/index.shtml
Types of Lasers Gas laser (CO2-welding, surgery)
Excimer UV laser (LASIK)
Solid-State laser Semiconductor
(Telecom, Optical Storage, Laser Pointers)Fiber Hosted
(the PILOT Diode Laser) Others--
◦ Chemical Laser, ◦ Photonic Crystal Laser, ◦ Dye Laser, ◦ Free Electron Laser, etc.
Power Variations
High Power Lasers and Low Level Lasers
What is a Laser?
Low Level Lasers: Used for the stimulation of cell function.
Their biological effect is not thermal, as is the case with surgical lasers.
i.e. LED laser
High Power Lasers: Used to cut, coagulate and evaporate tissues.
Often called surgical lasers because they can replace the scalpel of the surgeon.
i.e. CO2 laser
What is a Laser?
Based on Various Settings:
High Power Laser Actions◦ Vaporization◦ Hemostasis
◦ Decontamination
Low Level Laser Therapy◦ Biostimulation
◦ Modulation of Pain
What is a Laser?
Vaporization = Cutting
◦The diode laser’s wavelength is absorbed by pigmented tissues and cellular structures resulting in an incision similar to a surgical blade
◦ Less thermal damage than other Surgical lasers! CO2 laser works by boiling water in tissues
and rupturing cell membranes
What is a Laser?
CO2 Laser works by thermal action, therefore,
some thermal damage is inevitable!
What is a Laser?
Diode Laser Histology-Pulse and Continuous Modes
Less thermal damage results in less inflammation,
and therefore, less swelling and pain
What is a Laser?
Hemostasis
The diode laser’s wavelength is absorbed by hemoglobin
Surrounding tissue collagen contraction results in the restriction of blood vessels in the targeted area
What is a Laser?Surgical Incision Demonstration:
Coagulation Followed by Steel Blade
Active Bleeding Greatly Reduced on Treated Half
Based on the platform of the worlds leading dental laser
Over 3,500 model 2.4G used worldwide
The Pilot Laser
A Multi-functional Diode LaserUpgraded and Designed Specifically for
Veterinary Medicine
The Pilot Laser
The Pilot Laser
How Do Lasers Work?
How Do Lasers Work?
Staphylectomy
OPTIONS:
“Cut & Sew”HemorrhageDifficult in small mouth
ElectrosurgeryPost-op swelling
CO2 LaserRisk of charring or lasing pharynx
Diode Laser ?
Case Findings
•Zero bleeding
•Limited charring in portion used as “cutting”
•Portion used as “pre-coag” followed by blade worked well
•No dyspnea during recovery
•Eating baby food in 18 hours
Extraction Site Management forCoagulation and Decontamination
Typical Bleeding of Inflamed Extraction Sites
Treatment with Diode Laser
Following Diode Laser Treatment-
Bleeding Stops
Simple, Fast Extraction Site Closure
Low Level Laser Therapy (LLLT)
Also Known As◦Biostimulation◦Photobiomodulation◦“Cold Laser” therapy ◦3LT
Because… The mechanism is
photochemical rather than thermal
Lower settings- don’t cut!Improve Cellular Healing
Light is absorbed by mitochondria in cells
Stimulation of cellular ATP production and up-regulation of nitric oxide
Secretion of growth factors, activation of enzymes and other secondary messengers◦Enhanced cell proliferation and differentiation
Lower settings- don’t cut!Improve Cellular Healing
Increased neovascularization and temporary vasodilation
“Photomodulation of Blood”– new term in medicine◦Enhanced leukocyte (WBC) infiltration
◦Increased macrophage activity
Lower settings- don’t cut!Improve Cellular Healing
Increased proliferation of cells◦Fibroblasts◦Endothelial cells◦Keratinocytes
Shown to be true of hypoxic or stressed cells
Healthy cells show little or no response
Tissue Repair
Rapid Regeneration of:◦ Skin◦ Muscle◦ Tendon◦ Ligament◦ Bone◦ Nerves
Periodontal Disease Pocket Management
with Diode laser
Periodontal Disease Pocket Managementwith Diode laser
24 Hours– no “red line”Gingivitis Resolved
2-yr.-old Male Tinkerbird
Chronic Scalp WoundFollowing Trauma
Minimal healing over 1st month-Duoderm Paste used
2 yo Male Tinkerbird
Lesion size after 1 month– outlined in red
Lesion size 24 hours later, following treatment with the Pilot Diode Laser- outlined in green
2 yo Male Tinkerbird
Lesion-- 7 days, four treatments later
6-week-old female Border CollieInjection Site Abscess
•Base of skull on right to caudal scapula•E. Coli was cultured from the wound•Littermates also affected
6-week-old female Border Collie-Injection Site Abscess
Immediately Post-Op
Treated only caudal half of incision with diode laser following typical debridement
6-week-old Female Border Collie
Day 4 post-op- Caudal (treated) half shows epithelialization
6-week-old Female Border Collie
Day 4 post op-Cranial (non-treated) half has more scabbing and
inflammation, no epithelialized areas
Following day 4, the entire the wound was treated with the Pilot Diode Laser
6-week-old Female Border Collie
At 15 days post-op, the entire wound was nicely healed with an atypically large amount of new hair
growth.
Untreated littermate at day 17
Barking Tree Frog presenting for swelling and inflammation attributed
to Red Leg Syndrome
Infectious dermatitis in this frog was non-responsive to antibiotic baths and topical treatment.
The prognosis was terminally poor.
Barking Tree Frog with Red Leg
When laser therapy was introduced, antimicrobial treatment was
discontinued.
Leg after 2 Weeks of Diode Laser Therapy
Diode laser therapy was applied at 2.0 watts for 2 seconds, twice weekly for four weeks.
Barking Tree frog with red leg
Leg following 4 weeks of Diode Laser Therapy
Adult Male Barn OwlFound Caught in Soccer Net
Complete Degloving Injury of Left Humerus
Adult male Barn Owl
Treated with Diode Laser at 2.0 watts for 2 minutes Every Other Day for 2 Weeks
Adult male Barn Owl
No scabbing of the wound was ever noted
The owl was released into the suburban wild at 2 weeks
Modulation of Pain
In General Increases release of endorphins Increases serotonin Resolution of inflammation at least
equivalent to NSAIDs Suppression of nociceptor action
◦Inhibits nerve conduction in small and medium diameter peripheral nerves
Modulation of Pain
Joint Pain Specifically Joint capsule and synovial membrane stimulation
result in increased intra-articular circulation and ◦ healthier synovial fluid is generated◦ Chondroblastic cellular formation is accelerated
Modulation of Pain
Suppression of nociceptor action◦ Localized treatment ◦ Inhibits nerve conduction in small and medium
diameter peripheral nerves
Induces neural blockade reducing central nerve sensitisation (pain memory)◦ Spine and trigger point treatment
Human Medicine
chronic pain acute
(traumatic) pain
tendonitis carpal tunnel
syndrome tennis/golfer
elbow
acne, eczema inflammatory
skin conditions wounds and
burns non-healing
ulcers rheumatoid
arthritis fibromyalgia lymph edema osteoarthritis
migraines
sinusitis, tonsillitis
TMJ disorders
Minere’s disease
Tinnitis vertigo
There are > 50 positive Double Blind studies that show clear evidence that Low Level Laser Therapy (LLLT) is highly effective for the following conditions:
http://www.drz.org/asp/cp/laser2.asp
Human Medicine
Cosmetic Uses◦ Hair Re-growth
◦ Dental bleaching
◦ Non-surgical face lift and wrinkle correction and body contouring
◦ Non-surgical liposuction
◦ Laser enhanced breast augmentation
What Can Veterinarians Treat?
Anything With Pain…
Back Pain Bowed tendons Navicular disease Bucked shins Laminitis Cellulitis Joint Pain Suspensory ligament desmitis
Anything With Infection…
De-gloving injuriesChronic Otitis ExternaGingivitis/PerioTooth abscessesBite woundsHot SpotsFolliculitisPododermatitisLick GranulomaAnal Gland abscessesRhinitis
Anything Needing Surgery…
9 watt maximum
Programmable
Patented fiber management system
Easy to use handpiece and tips
Bright and easy to read display
Safety features
Portable – light weight
Pilot Features
Variable 0.1 - 9 Watts 400 micron fiber Continuous or pulse mode Portable – 5.5 lbs Unique/patented fiber management 20 ft. of optical fiber Easy and intuitive to use Wireless foot pedal Aiming beam Disposable tips
Pilot Features
Fiber Management
The patented fiber management system goes where you want it.
The handpiece feelsand acts like a scalpel.
Pilot Features
Minimal invasion into surgical area. Fiber will extend out to 20 ft.
Pilot Features
Scalpel-like Handpiece
Easy to use.Straight or curved.
Pilot Features
Disposable Tips
This essential feature aids the surgeon in visualizing exactly where the laser will ablate and incise tissue, before laser energy is delivered.
Pilot Features
Aiming Beam
.1 - 9 Watts of power.Delicate enough for biostimulation while powerful enough for daily surgery.
Pilot Features
Extended Range of Power
Scope Compatible
Laser fiber easily inserts through laser port
Works with any scope procedure…unlike CO2
Pilot Features
Surgical Incision Management
Photo-contraction causing Hemostasis
Controlled Bleeding
Pre-coagulation Followed by Steel Blade
Procedures
Photo medicated portion of incision has NO BLEEDING
Bleeding No Bleeding
Photo taken within 5 seconds of incision
Half of incision photo medicated
Surgical Incision Management
Procedures
Improved cutting instrument
• Scalpel-like cutting• No bleeding• Reduced thermal damage
Canine Neuter
Procedures
Induce perianesthesia with laser, excise mass with scissors, coagulate and vaporize lesion to char 5 days/week
Lesion and Mass Removal
Procedures
Feline Declaw
Procedures
Photo courtesy of Dr. Jan Bellows
Gingival Hyperplasia
Scalpel-like cutting with No bleeding
Pre marked with absorption accelerating ink
Dental
Procedures
Periodontal Decontamination
Procedures
Root Canal Decontamination
Procedures
Apex Decontamination
No BleedingEasy to use
Elongated Soft Palate ResectionStaphylectomy
Procedures
Ear infection and Otitis Externa account for approximately 20% of clinical case load
Auricular Treatment Tip
Photo courtesy of Dr. Jan Bellows
Otitis Externa
Procedures
A Multi-functional Diode LaserUpgraded and Designed
Specifically for Veterinary Medicine