Читать книгу Surgery of Exotic Animals - Группа авторов - Страница 30

The carbon dioxide (CO₂) laser (Aesculight; LuxarCare LLC, Bothell, WA) gained popularity in veterinary surgery in the 1990s and continues to be in common use today. CO₂ lasers produce a beam of intense light at a wavelength that is highly absorbed by water molecules. It cuts tissue when the beam is very focused and coagulates for hemostasis when it is more diffused. The CO₂ laser seals vessels <0.6 mm, so most skin incisions are bloodless with minimal or no bruising. It also seals lymphatic vessels and nerves so there is less swelling and reportedly less pain associated with incisions compared with those made using a scalpel. When used with correct technique, the amount of lateral heat damage is minimal (Harkness et al. 2010); however, when used incorrectly, lasers can cause significant thermal damage.

In addition to being able to incise skin and other tissues, CO₂ lasers can also be used to fulgurate or destroy tissue, such as a tumor or the tissue bed after a tumor has been removed in an effort to eliminate residual microscopic disease. Use a high‐power setting and keep the tip as close to the tissue as possible when cutting tissue. Do not touch the tip to the tissue. If there is hemorrhage, move the tip farther from the tissue, which will diffuse the beam and coagulate vessels. Use a smaller tip to create a small spot of light which will then cut better with less collateral heat. A wider tip will not cut as well and will cause more heat damage, but will also control hemorrhage better by coagulating vessels. Proper safety training for all personnel is important when using surgical lasers.