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