2014年3月24日星期一

Effect of diode laser coagulation treatment on grade III internal hemorrhoids

OBJECTIVE:

To evaluate the curative effects of diode laser coagulation on grade III internal hemorrhoids.

METHODS:

From March 2004 to December 2004, 86 patients with grade III internal hemorrhoids were divided into two groups, received lasercoagulation (laser group, n=46) or received hemorrhoidectomy (control group, n=40). Complications, symptom relief, pain scores and satisfaction scores were compared between the two groups six months after operation.

RESULTS:

Pain scores were lower in laser group than that of the control group on the first day and seventh day after operation. Small amount of bleeding occurred in the laser group (12 cases) and control group (35 cases), however, non of them required special hemostasis. Laser coagulation and closed hemorrhoidectomy were equally effective in controlling symptomatic prolapse. There was no difference in terms of continence scores and patients satisfaction between the two groups (P> 0.05).

CONCLUSIONS:

Diode laser coagulation can be considered as a safe and effective procedure for the treatment of grade III hemorrhoids.

donna@gigaalaser.com

A new method for hemorrhoid surgery: experimental model of diode laser application in monkeys

OBJECTIVE:

Detailed here is an experimental model in monkeys of a new approach to treat hemorrhoids using a diode laser.

BACKGROUND DATA:

Hemorrhoids are a common source of pain and suffering. Endovascular laser therapy for variceal veins is a method that potentially could be used in the treatment of hemorrhoids. There is currently no such method described in the literature.

MATERIALS AND METHODS:

Hemorrhoids were induced in monkeys by ligation of the inferior hemorrhoidal vein, similar to their cause in humans. After the piles were identified, laser fibers were introduced into them, and they were irradiated with laser energy (810 nm at 1-2 W in 1-sec pulses of 1-2 J each, for a total fluency of 4-10 J).

RESULTS:

The piles were completely reduced, and histological examination performed 10 d post-surgery showed reduction of the dilated vessels and complete healing. The laser energy was not delivered directly into the veins, but instead to the surrounding submucosal interstitial tissue, effectively reducing the hemorrhoids.

CONCLUSION:

The diode laser energy delivered into the hemorrhoids led to their complete resolution. Further clinical trials using this protocol must be carried out to determine its applicability to human hemorrhoids.

donna@gigaalaser.com

Diode laser for treatment of symptomatic hemorrhoid

Hemorrhoid is protrusion of plexus or blood vessels in the anal canal. 

The hemorrhoid may cause symptoms that are: bleeding, pain, prolaps, itching, soilage of feces, and psychologic discomfort. There are many methods for treatment of hemorrhoid like, medical therapy, cryo-therapy, rubber band ligation, sclerotherapy, laser, and surgery. All methods have some complication in postoperative period and recurrence.

THE AIM OF THE STUDY:

Was to evaluate Diode laser for treatment of hemorrhoid.

MATERIAL AND METHODS:

This study included patients who suffer from the hemorrhoid. Cases with fistula and fissure had been omitted. Patients with hemorrhoid in grade 2, 3, 4 and mixed were treated with diode laser. Follow up was done 1,7,14, 30, 90, and 360 days laser therapy.

RESULTS:

In this study, 341 patients with hemorrhoid treated with diode laser were included. Results of follow-up were as follows: need for analgesia in hospital stay and home was very low total complication was seen in 12 patient (3.51%), edema in 8 patient (2.34%), hemorrhage and abscess each of them in 2 patient (0.58%), stricture and recurrence was zero after one year.

CONCLUSIONS:

All methods used for hemorrhoid treatment has advantages, disadvantages, and limitations. But treatment of hemorrhoid by Diodelaser, which is done by skilled surgeon has several advantages over other treatments. This advantages include, less operation time, less pain and bleeding, allow quick healing of piles, no stricture, and minimal recurrence after operation.

donna@gigaalaser.com

Laser proctology surgery

What are hemorrhoids and how often they are faced?
At birth everybody has a vascular plexus around the rectum, mostly consisting of veins. It has a specific function –  function of barrier. Often, during the lifetime, this vascular plexus is affected by various factors and as the result enlarges and begins to disturb. This situation is then known as hemorrhoids.
Up to 50% of all EU citizens are faced with problems or discomfort in this regard. Both men and women are struggling with hemorrhoids. The highest risk of experiencing the hemorrhoid problems is between 45 to 55 years, although in practice it's possible to see very young and very elderly patients with hemorrhoid problems.

How hemorrhoids let know about itslef?
Presentations are very different. Discomfort in the rectal area, itch, spotting (fresh) at the bowel, inflammations (painful formations in the rectal area), at the later stages nodes in the time of dejection or physical exertion.
Hemorrhoids don’t have specific symptoms. There may be similar symptoms in the cases of relatively harmless diseases (small rupture of the mucous coat, small polyp, etc.) or very serious diseases (cancer, rectal inflammations - ulcerative colitis and Crohn's disease), requiring immediate and serious treatment.

The hemorrhoid problems can be solved only surgically?
People often have the impression that the surgeon-proctologist should definitely operate every patient. There are cases, when it’s necessary, but there are also other methods of treatment. The main problem is to go to the proctologist, and then to continue the dialogue.

Is it necessary to prepare something specific for the visit to the proctologist?
The first visit does not require any specific preparation. Some people think that it’s forbidden to eat or drink during the whole day, or use any medicines for bowel cleansing  - it is not necessary. If a person subjectively feels that it will be better, he can make one microclyster with non-prescription medicines, bought in pharmacy, but this is not obligatory. If during the preparation for a specific procedure some additional actions will be necessary, the doctor will tell about them in details. No medicine,  prescription or non-prescription, should not be used unnecessarily. Patients of laser medical clinic patients are provided with the most discreet and delicate attitude and comfort, which are not less important.

Which technologies are used during surgery?
By using a laser, the haemorrhoids nourishing blood vessels are burned up. Studies have proved that in case of enlarged haemorrhoids, these blood vessels are badly enlarges, the circulation of blood is increased. This method is mostly being used at early stages of hemorrhoids, when the nodes in anal orifice are not observed, but the patient has more complaints directly on the bleeding.

With the use of  laser technology for more complex haemorrhoid problems, in the hemorrhoid node is sticked a “laser needle” and burning up is performed, leading to node flattening, so to say - stick to the gut wall. It’s very accurately estimated how much energy is needed for this purpose, in order to prevent affection of the sphincter or rectal mucosa. This can be local anesthesia, with the help of a special barrier, but there are situations, when the surgery requires anesthesia (usually spinal or intravenous anesthesia).
The pain is not very strong, but there is a physiological burn, certain discomfort and the anaesthetic pills should be used, but in terms of pain that is not comparable to the classical operation. In general, several hours should be spent in the clinic. If the patient lives far away, operation is scheduled for afternoon or the disease degree is high, we offer to stay in hospital for the night.

donna@gigaalaser.com

Gbox15B Nail Fungus Therapy Laser

Treatment Parameters



It depends on the  spot size  so I will give you a few protocols 
600 micron fiber  one cm away from toe nail //// T on  3 ms  /////     T off  30 ms  ////  total joules 500 joules hallux toe nail ///  250 joules   less toes//// PEAK POWER 15 watts  

You may have to turn down the  PEAK POWER  to 10-15 watts if the  patients feel too much heat.  or you can  increase the T off  40,50 ms I prefer to  keep with 15 watts and adjust the T off to 40 ,50 ms
If you can't adapt to this protocol  Use  650 us Ton and 650 Toff  . Some doctor have power learning how to move the handpiece so we start with this protocol and with experience move to the  first protocol
Remember if its too hot  and it all depends on patient you stop place finger on toe nail and press will cool the  nail. Then adjust the  power and or the T0ff. I like to adjust the Toff instead of reducing the peak power down from 15 to 12 watts. Also this is at least  three treatments 30 days apart. This is a painting motion with the hand piece.

donna@gigaalaser.com

IDEM Singapore 2014/April 4 – 6, 2014

IDEM Singapore 2014/April 4 – 6, 2014



Welcome to visit Gigaa Medical Laser at IDEM Singapore 2014
The leading dental trade fair and scientific conference in the Asia-Pacific IDEM Singapore 2014 will be held in SUNTEC Singapore.
We are looking forward to meet you during IDEM Singapore 2014 , please visit our booth at Level 4, Booth No. 4L 29.

donna@gigaalaser.com

2014年3月18日星期二

IDEM Singapore 2014/April 4 – 6, 2014


Gigaa Laser- EVLT





donna@gigaalaser.com

FAQ About the EVLT



How long will it take to recover from a Endovenous Laser Ablation (EVLA) treatment?


EVLA is a ‘walk-in, walk out’ procedure so you will be able to leave the clinic after treatment. You will be advised to wear compression stockings after treatment because these apply constant pressure to the legs. This will reduce bruising post-treatment and will ensure the treatment effectively targets the unwanted veins to offer results that are long lasting.
Aside from wearing support or compression stockings for about 2 - 3 weeks, you should be able to return to your day to day routine immediately.
You will normally be asked to return to the clinic for a follow-up check after a few weeks to have an ultrasound scan and discussion to assess the success of the treatment.

What are the risks and potential complications from Endovenous Laser Ablation (EVLA) treatment?

Expect side effects such as pain, discomfort, itching, swelling and bruising and a feeling of tightness or numbness in the treated leg(s) for up to a few weeks following treatment.
The removal of varicose veins does not affect blood flow. This is because the remaining veins in the leg, particularly the deeper (femoral) veins, take over this role.
Any operation on the leg carries a risk of Deep Vein Thrombosis (DVT). For example, with the old vein stripping method the associated risk was 5%, which is 15 times more that the 0.3% risk with EVLA.
In extremely rare cases small skin burns have been reported with EVLA.

What should you do after a Endovenous Laser Ablation (EVLA) treatment?

It is important to follow the advice of your vein specialist as closely as possible following EVLA to ensure that you get the full benefit of the treatment and avoid any complications.
Post-treatment advice may include:
  • Take over the counter anti-inflammatories or pain killers (ibuprofen or paracetamol) for a few days after the treatment, which will ensure you feel comfortable.
  • Wear the supplied or recommended compression stockings for the time period advised.
  • Plan for an average of three days off work post treatment although some people do return to work sooner (even on the same day), this depends on how you feel and your type of work.
  • Do plenty of walking post-treatment (ideally four miles per day for two weeks).
  • Avoid hot baths, Jacuzzis, steam rooms or swimming pools for two weeks after treatment.
  • Avoid drinking alcohol for 24/48 hours following treatment.

Who should not have Endovenous Laser Ablation (EVLA) treatment?

You should not undergo EVLA treatment if you are pregnant and many specialists will not treat patients who are breast feeding.
 If there is a history of past deep vein thrombosis (DVT), the ultrasound scan will need to pay particular attention to the state of the deep veins. If there is significant deep vein obstruction, EVLA may be inadvisable.
Other contra-indications include:
  • Active superficial vein thrombosis
  • Acute Deep Vein Thrombosis
  • Recent Long Haul Flights
  • Very superficial veins close outside the fascia and close to the skin
  • Very tortuous veins which cannot be negotiated by a straight laser catheter

EVLA is very safe and can be performed in the presence of many medical conditions and without the need to stop medications such as anti-coagulants.

Summary of Endovenous Laser Ablation (EVLA) information

Endovenous Laser Ablation (EVLA) is a safe, effective and minimally invasive treatment option to remove varicose veins. The technique has been developed and perfected for well over a decade.
It is a ‘walk-in, walk-out’ procedure which produces very little downtime for the individual with good results that last longer than those seen with traditional surgical stripping operations.
With new guidance from NICE, this treatment may be accessible on the NHS as well as through private clinics.



donna@gigaalaser.com

What happens during an EVLA treatment?

Although most of the time a venous reflux problem is visible through the presence of the distended varicose veins close to the skin’s surface, in some people the problem still exists but with no apparent signs on the surface of the leg. Such people may simply have visible thread veins or in some cases nothing at all.
Most vascular surgeons and vein specialists therefore advocate the use of ultrasound diagnosis as best practice when dealing with a person who presents either with a visible problem or any symptoms associated with vascular problems. Without being able to see the underlying venous system a practitioner cannot properly assess whether there is an issue with venous reflux which is causing the cosmetically unattractive varicose or thread veins which you have asked them to treat.

Sometimes you can pay for just this ultrasound scan separately; expect to pay about £150, in order to correctly diagnose the problem and to help you and the practitioner decide if EVLA is a suitable treatment option for you or if something else would be better suited.

On consultation with a vascular specialist a detailed discussion will take place which should clearly highlight your expectations of the EVLA treatment. The practitioner should then be able to explain the treatment and potential results to you.

A medical history will be taken to make sure that there are no reasons why you are not suited to be treated with EVLA. Then you would normally be asked to sign a consent form, which means that you have understood what the treatment may do, and the potential side effects.

Photographs may also be taken by the practitioner that can be used as a “before and after” comparison to show you how successful your treatment has been from a cosmetic perspective.

The procedure
An ultrasound scan is used to mark the position of the veins and identify the problematic areas.
Local anaesthetic is then injected around the vein to ease any discomfort that might be created through the treatment. A small needle is first inserted into the targeted vein through a very small incision and a fine probe or thin laser fibre is then inserted through the needle up the vein; the incision is usually close to the knee. The laser energy is delivered in short or continuous pulses to seal the faulty vein so that blood can no longer flow through it. The incision point is then sealed with surgical tape and will heal over quickly.
A compression stocking is then applied on the leg to reduce subsequent swelling and bruising. You will normally be asked to stand and walk immediately after the procedure.

The procedure usually takes between half an hour to a couple of hours to perform, depending on how many veins and how many legs are being treated. Afterwards you can go home without the need for a hospital stay. The treatment removes both the appearance of the varicose veins and the discomfort caused by their presence.

donna@gigaalaser.com

1470nm Endovenous laser ablation for saphenous vein insufficiency

Objective The present study aimed to evaluate the efficacy of endovenous laser ablation with a 1470-nm laser and to analyze the short- to mid-term results of endovenous laser ablation procedures to treat great saphenous vein insufficiency.

Method In this retrospective study, 200 patients (230 limbs) with symptomatic varicose veins secondary to great saphenous vein insufficiency treated with 1470-nm endovenous laser ablation were studied. Patients were evaluated clinically on the first day, first week, first month, and sixth month after the operation. Treated limbs were evaluated as separate treatment events.

Results The short-term occlusion rate was 99% and mid-term occlusion rate was 100%. Induration or swelling was the most common minor complication (13%). No major complication such as deep venous thrombosis and pulmonary embolus occurred. Preoperatively documented mean venous clinical severity score significantly reduced from 4.9±2.3 to 2.5±1.1 (p

Conclusion Endovenous laser ablation procedure of great saphenous vein with a 1470-nm diode laser is a minimally invasive, safe, and efficient treatment option in all-suitable patients with high short- and mid-term success rate.

donna@gigaalaser.com 

2014年3月10日星期一

The evolution of laser therapy


High Power Therapy- Working Mode


donna@gigaalaser.com

Different Wavelength for Therapy Treatment

The three wavelengths: 810 nm, 980 nm and 1064 nm, even if contained within
the therapeutic window, have different characteristics, above all in their specific
interaction with chromophores.


donna@gigaalaser.com

High Power Therapy Laser Effect

Analgesic Effect
Rapid pain relief with no side effects:
Thanks to the innovative emission mode,it allows energy modulation to
quickly combat muscular and joint pain.

Anti-inflammatory Effect
It modulates the inflammatory processes thanks to its deep
stimulation of tissues, triggering vasodilation, increasing oxygenation
and therefore activating the main metabolic activities.

Bio-stimulant Effect
The high power laser works by facilitating energetic cellular processes,
increasing the remodelling of tissues by stimulating the production
of collagen.

donna@gigaalaser.com

High Power Laser-Maximum working depth

Many pathologies which afflict the muscular system are at depth. When the cause of a pathology is at such depth, it becomes difficult to reduce the pain. In these cases laser therapy is of fundamental importance: the beneficial effects it can bring about facilitate optimal physical recovery.

An advantage of laser therapy is its ability to work at depth and to resolve the cause of the pathology at its point of origin. This characteristic can be attributed to two properties of the laser: wavelength and power.

As is known, different wavelengths have different properties in terms of diffusion and absorption by human tissues, and for each therapeutic objective it is possible to select the most suitable wavelength.

The emission power also increases the effectiveness of the laser, transmitting the beneficial effects to great depth. The greater the power transferred to the tissues, the greater the energy transmitted to the injury.
Therefore power is the main carrier in the transfer of energy.

Interaction between power and depth (with the same wavelength)
The ability of the laser to penetrate to depth is often incorrectly attributed to only the wavelength.
In reality, the power has a fundamental role in the therapeutic action of the laser on tissues.
It is known that the power (Watts) represents the quantity of energy which can be transferred in one unit
of time (1 Watt = 1 Joule for 1 second). Energy reduction is inversely proportional to the reference depth.
Greater power transmits more energy, overcoming the natural dispersion of the laser and reaching the seat of
the injury (see diagram opposite).
The more energy transferred, the greater the quantity which can be assimilated by the tissues.

2014年3月5日星期三

Spider Vein User Manual

The clinic user manual for Spider Vein provided by GIGAALASER is only the guideline for the treatment, GIGAALASER only take full quality responsibility of laser device within warranty and declare no responsibility for any damage caused by wrong use of laser device, improper procedure during treatment. 

1 Laser device and accessories 

(1) One set of VELAS30A (30W 810nm) diode laser system.
(2) Protective glasses for patients, surgeon and assistants.
(3) Focus handpiece with three spot sizes
(4) Skin cooling system or skin cooling packs


2 Treatment Procedures (Leg vein for example)
User settings with the VELAS laser:

Indication





(1) There are three kind of focus handpiece connector available with the spot size diameter 0.5mm, 1.0mm and 1.5mm, please choose the right focus connector according to the size of leg vein.

(2) Set the menu in repeat mode and choose the low output power of laser firstly to check the performance of treatment.

(3) Use the skin cooling system or skin cooling packs( ice) to reduce the patient pain before and after laser application.

(4) Dry the skin before continuing laser application.

(5) The pulse length is basically responsible for the pain feeling. The Power setting of the diode laser determines the penetration depth. The repetition rate determines the pain feeling fundamentally (relaxation time).
(6) Swelling of the treated tissue is a result of the overheating in the tissue. The higher the power of the diode laser, the more effect will occur. 

(7) Immediate cooling of the tissue reduces the pain feeling and the swelling can be reduced too.



3 Post-operation Attention 

(1) Use the cooling system to release the pain for 20—30 minutes.

(2) Keep the skin clean and keep away from water.

(3) Do not use the cosmetic before crusta falling.

(5) Avoid too much sweat to slow the skin recovery.


(6) Laser retreatment if recurrence of superficial varicose veins


Deep Tissue Laser Therapy

Laser therapy has been in use for over 30 years around the world with no known side effects. When operators are trained in laser safety, the laser is safe to use in practically and facility. Protective eyewear is provided for both patients and clinicians. The trend in laser therapy for the past 10 years has been to increase power density and dose, since this has been shown to improve therapeutic outcomes considerably. So we recommend the deep tissue laser therapy. Deep tissue laser therapy does not require the use of drugs or surgery, and there are no known side effects or risks that may occur with other forms of treatment. In addition, it can often achieve results faster than other treatment modalities. During the treatment the patient will feel deep soothing warmth. This pleasant sensation reassures the patient that the laser is stimulating cellular activity. Your new laser therapy business runs parallel with your current practice, improving patients’ outcomes, expending your scope of practice, building and cross-referring new patients and increasing cash flow. Offering laser therapy keeps your practice on the cutting edge of technology, which is important when differentiating yourself from other practices in your area.
  • Pain associated with soft tissue injuries:
  • Back pain and spinal conditions
  • Cervical neck pain
  • Carpal tunnel syndrome
  • Myofascial trigger points
  • Epicondylitis (Tennis elbow)
  • Sprains, strains
  • Repetitive motion injuries
  • Plantar fasciitis/ fasciitis

  • Biological effects of therapeutic laser therapy
  • Accelerated tissue repair and cell growth
  • Faster healing of injuries
  • Reduced fibrous tissue formation
  • Anti-inflammatory
  • Analgesia though the release of endorphins, brandykinins ect
  • Improved vascular activity
  • Increased metabolic rate within the tissue
  • Improved nerve function

The laser utilizes a non-contact treatment method. This non-contact treatment method makes it significantly easier for the clinician to provide treatment. Compare this to many other low level or cold lasers that require strenuous pressure applied to the surface of the skin. Delivering a larger number of photons per area, the larger spot size of the treatment handpiece (Therapy handpiece set) makes treating area faster, and allows the clinician to treatment more patients with greater efficiency and improved results. Patients respond favorably to faster treatment times with increased compliance for follow-up treatment sessions. If the power density is too low, the laser treatment is ineffective, if the power density is too high, the laser can cause tissue damage.

So our therapy handpiece set is able to maintain a safe power density due to its larger spot size (Adjustable spot diameter: 10mm/15mm/20mm/25mm/30mm it can control with hand switch). The biological effect of laser therapy is related to the wavelength of light emitted by the laser. The shorter the wavelength, the more readily the energy is absorbed and scattered in the body before it reaches the target area. Generally the longer the wavelength (up to 1200), the deeper the penetration of photon energy. Simply stated, if you cannot reach it, you cannot treat it.

High Power Diode Laser Therapy

For pain therapy treatment, the two key factors decide the therapy results are:
A. Deep penetrating ability
B. The energy applied in the treated area

The penetrating ability is decide by the wavelength. The 980nm wavelength (diode laser) has very deep penetrating ability. Thanks to this, the laser energy of high power diode laser can reach the deep tissue and be absorbed by the deep tissue. The cell absorb the laser energy and then it will produce the ATP, making the cell perform it normal function. The result including reduce pain, inflammation and helping wound healing etc.

The high power diode laser's max power can reach to 15-60W (almost 30-120 times higher than low level laser therapy treatment). Thus, in the same time, if the power is more higher, more energy will be applied in the treated area. It will make the therapy treatment more quickly and the therapy result more effective.

2014年3月4日星期二

HERA600A (600W 810nm) diode laser for hair removal

Clinic Explanation:
The 810nm diode laser be seemed as “golden standard” for hair removal. It provide you no pain, fast, uniform, permanent hair reduction for the widest range of skin and hair types - without sacrificing comfort.

The Diode laser hair removal system involves a beam of concentrated light and heat 
that is directed into the hair follicles, and therefore to the melanin contained in them. 
The pigment absorbs the laser energy and is destroyed, inhibiting hair growth in the 
affected hair follicles. The laser energy is directed at these follicles while simultaneously protecting the surrounding skin from harm. 

The Diode laser method of hair removal may involve several treatments. Each session 
with the laser is fast, and there is little to no down time. Side effects from Diode laser 
hair removal are minimal, but there may be redness on the treated area. This redness 
should disappear within two days. 


Related Keywords:
Hair removal, depilation, painless, safe 


Medical device:
HERA600A (600W 810nm)


Operation procedure:
1. Building files for the patient. Recording the patients condition and take photos before & after the treatment per treatment.
2. Removal hair by knife thoroughly and keep the treated ared clean.
3. Sterilizing the treated area and treatment handpiece.
4. Applying cooling gel in the treated area.
5. Keep the handpiece directly to the skin and press it slightly to sure the handpiece has close with the skin.
6. Generally speaking, choose the energy from 18J/cm2 to 40J/cm2 according to the hair density. If the hair density if big, then less energy need to applied in the treatment area to avoid over heat. The user can add energy when the hair become few and scatted after several treatments. 
7. A course of treatment include 1-5 treatments. The interval of each reatment is 3-6 weeks. Some cause may need about 2-3 courses of treatment.
8. Ice cooling the treated area after finish the treatment. And applied the antibiotic gel in the treated area if need. 


Notice:
Ø The hair removal is not suit for the pregnant and the people who have cancer, especially the dermatology cancer. 
Ø Do not be exposed to the sun before the 3-4 weeks of the treatment, and also after the treatment.
Ø Do not to eat spicy food.
Ø Do not use other methods to removal the hair during the treatment period.
Ø Do not wear deep color or dirty underwear after the treatment.
Ø Do not press the treated area where become the red after the treatment.

IDEM Singapore 2014/April 4 – 6, 2014

Welcome to visit Gigaa Medical Laser at IDEM Singapore 2014
The leading dental trade fair and scientific conference in the Asia-Pacific IDEM Singapore 2014 will be held in SUNTEC Singapore.

We are looking forward to meet you during IDEM Singapore 2014 , please visit our booth at Level 4, Booth No. 4L 29.