Refractory Glaucoma Treatment

Refractory glaucoma treatment with Gbox15W 810nm diode laser from GIGAALASER

Clinic Explanation:

Glaucoma is an eye disease in which the optic nerve is damaged in a characteristic pattern. It is normally associated with increased fluid pressure in the eyes.

Refractory glaucoma refers to the applications of drugs and surgeries are difficult to control glaucoma.

DLTSCPC (Diode Laser Transscleral Cyclophotocoagulation) is a simple, safe and effective therapy for eyes with refractory glaucoma.

Related Keywords:

Refractory glaucoma, DLTSCPC, safe, diode laser

Medical device:

Gbox15w 810nm

Power: 1.5-2.5w

Mode: Pulse 

Accessories:

G-probe (600um fiber) 

Operation procedure:

1. Make patient supine.

2. Anesthesia. Across retrobulbar anesthesia.

3. Place the laser fiber in contact with the first central government after the corneosclera

margin of 1.5 ~ 2mm department. 

4. Make the G-probe directed towards the ciliary body crown. Laser energy use is 1.5-2w, time 0.5-1s, 24-34 hit spots, each spot between the internal of 1.5-2.0mm

5. Initial power setting is 1.5w and then adjust the power with 0.1w steplength until hear the “popping” sound. Using this power finish the treatment.

6. After the treatment, partial adrenal cortex hormones and antibiotics given to drug points, eyes, and symptomatic use IOP lowering drugs. Oral pain medications when necessary.

Advantage:

1. More safe and effective. The 810nm diode laser for the near-infrared light, the penetrating strong selectively absorbed by pigmented ciliary body, destruction ciliary epithelial cells, so that a decrease in aqueous secretion to reduce intraocular pressure.

2. Not only can effectively relieve pain, but also to reduce the intraocular pressure to a lower level and protection of remaining visual function.

3. No serious complications after surgery, when the intraocular pressure increased again, it can repeat the treatment. The interval of treatments is better more than 1 month.

4. Simple and low price.

Notice:

1. Avoid excessive photocoagulation

2. 3 and 9 o’clock positions were spared to avoid the long ciliary nerves during the treatments

3. DLTSCPC surgery on the ciliary body injury is a non-reversible damage, so we are now only used in the clinical phase of the late and absolute glaucoma with poor visual function.

Laser PLDD

VELAS30W 980nm diode laser for PLDD treatment from GIGAALASER

Clinic Explanation:

PLDD (Percutaneous Laser Disc Decompression) be acknowledged as the most effective minimally invasive surgery for spine. The laser energy is introduced by a fiber inserted to the nucleus pulpous under the monitoring. Then the herniated intervertebral discs are treated by reduction of intradiscal pressure though laser energy.

Thanks to VELAS30B with 980wavlength which have a good absorption of water, enable the PLDD procedures to be carried out safety, accurately, less bleeding and pain.

Related Keywords:

PLDD (Percutaneous Laser Disc Decompression), lumbar disc herniation, minimally invasive surgery, less bleeding and pain

Medical device:

VELAS30W, 980nm

Mode: Pulse, 

T-on: 1s, T-off: 3-5s

Operation power: 15-18w

Accessories:

600um fiber, PLDD set,

Operation procedure:

1. Make the patient place in prone position on CT table.

2. Decide the puncture point and pathway by CT scanning.

3. Local anesthesia.

4. Insert the 18G puncture needle in the midline with 8cm deep, pointing toward the centre of the disc. Verify the needle in correct position by CT imaging.

5. Removal the stylet of the needle and then insert the 600um bare fiber. Make the tip of fiber expose about 3-5mm and then connect Y-valve.

6. Open the device, letting the laser energy vaporize the herniated intervertebral discs and then reduction of intradiscal pressure. During the operation, using the Y-valve for lymphosuction when patient feel swelling.

Advantage:

1. Minimally invasive operation, with no bleeding and no scar.

2. Easy to operation, the surgery can be done on local anesthesia and more quickly.

3. Can treat several intervertebral discs disorder at same time.

4. The surgery do not involve in operation in the inner of canales spinalis, so it less or no complication after the surgery.

5. Less pain and discomfortable, enable the patient quickly back to daily life

Notice:

1. Patients should be excluded if they had previous surgery at the indicated level, disc extrusion, and spinal stenosis.

2. In order to open up the posterior aspect of the disk space, soft pillow is positioned under the abdomen of each patient to place the lumbar spine in a semi-flexed position.

3. The total energy applied in each disc will decided by patients’ spine condition. The suggest energy is about 1200-2000J.

4. The patients are suggested to take bed rest for 1-3 days. 

5. Patients should are given mannitol and antibiotic therapy for 3 days.

6. Patients were instructed to avoid heavy lifting, heavy exercises and long time sitting or standing for 3 months.

Welcome to visit www.gigaalaser.com to get more info

Nasolacrimal Duct Obstruction (NLDO)

Nasolacrimal duct obstruction (NLDO) is a fairly common disorder clinically manifested by the presence of tearing, purulent discharge, and  less often, associated  with sterile or 

infected dacryocystitis. Although medical treatment including antibiotic therapy may address temporary relieve of the symptoms, most authors believe that surgical 

intervention is the choice of  management for primary or secondary nasolacrimal duct obstruction in which   patency of the lacrimal outflow system is restored. 

Related Key-words:

DCR,endonasal,laser,lacrimal sac.

Medical device:

 CHEESE 10W 980nm (1-10w continue.300J)

Accessories:

ENT handpiece,endoscopy

Operation procedure:   

1.General anethesia or sedation underwent nasal mucosal shrinkage and predisposing factors for NLDO 

2.Conect the fiber to the handpiece ,then connect to the device and test the laser if work normally.

3.Endocanalicular illuminating fiber or use the red pilot beam of the laser fiber helped in exact pin-pointing the lowermost part of the sac.

4.Through the handpiece into the canaliculus with harm to the lumen,burn the anterior attachments of the middle turbinate and lacrimal bone for 30 seconds to make a 1*1cm bony opening.Energy estimayed to be at least 300 joules.

Advantage:

In contrast to intra nasal drilling for bone removal, use of 

the laser is very simple and easier to usege

Notice:

1. Alaser fiber was then easily passed through one canaliculus to reach the medial wall of the sac. Intra nasal saline irrigation was used to 

    prevent thermal damage to the adjacent tissues.

2 A silicone tube was passed through the canaliculi in all the external and endonasal patients and kept in place at least  for three months

3.In both groups identical topical antibiotics and steroid drops were prescribed for one week. In cases of nasal anatomical correction, packing was removed on the third post operation day

4.Weekly office visits for one month and monthly inspection continued for three months when the tube was removed and the canaliculo-nasal fistula was irrigated.

5.Follow-up were scheduled three-monthly for nine further months with irrigation test carried out in each visit

Laser Dacryocystorhinostomy (DCR)

Related Keywords:

Dacryocystorhinostomy

Lacrimal surgery

Silicone stent intubation

Medical device:

VELAS 980nm 30watt

Power setting:

10 Watt,  

Ton 90ms(Pulse length),  

Toff 50ms (Pulse interval)

Accessories:

600um bare fiber

Introduction and Operation procedure:

The main technical obstacles in laser assisted DCR are to deliver a sufficiently powerful laser beam via a relatively narrow optical fiber, which in turn fits into an endo canalicular probe.

We will use 980nm diode laser in repetitive mode, Power 10Watt, Ton (Pulse length) 90ms, Toff (Pulse interval) 50ms. 

Osteotomy was achieved by applying laser energy via an optic fiber, which we inserted into the lacrimal sac with a probe. Irrigation with 0.9% saline solution of the endocanalicular probe was used to prevent overheating of the probe. The size of osteotomy was controlled through the nasal endoscope. Once an opening of at least 5 mm in diameter has been achieved, application of laser energy ceased.

Advantage:

1 Laser assisted DCR is a minimally invasive surgical procedure. It goes to the operating field  through lacrimal canaliculus. It will minimize trauma to surrounding tissue and avoid unnecessary surgical skin scars.

2 Totally no bleeding through laser surgery

3 Short operation time and quick recovery for patients.

Notices: 

1 Should find and examine lacrimal sac with a nasal endoscope.

2 Should pay attention to laser emission on surrounding tissues. 

Welcome to visit www.gigaalaser.com to get more info

Vocal Cord Lesion

Clinical Application:

GBOX 980nm diode laser for ENT treatment from GIGAALASER

Clinic Explanation:

The term vocal cord lesion or vocal fold lesion refers to a group of noncancerous (benign), abnormal growths within or along the covering of the vocal cord. Vocal cord lesions are one of the most common causes of voice problems. It includes vocal cord nodules, vocal cord polyp, vocal cord cyst and reactive vocal cord lesion. 

Related Keywords:

Vocal cords lesion; Laser surgery; Vocal cords benign diseases; Vocal cord leukoplakia.

Medical device:

Gbox15w 980nm: 

1. Noncontact, single pulse, 13w output

2. Contact, continuous, 5w

3. Contact and noncontact, continuous, 5w

Accessories:

400um fiber, ENT handpiece set

Operation procedure:

1.      Diagnosing the size of lesions (mini-sized <1mm, medium-sized lesions1-3mm, large lesions>3mm), and general anesthesia.

2.      Put the fiber into ENT handpiece. Setting parameters, with output power of 5w, the scope of a small white spot of the lesion, continuous noncontact exposure to disease solidification and vaporization; to a larger extent of the lesion, basement uplift of the lesion, continuous contact with radiation, the first noncontact exposure, is vaporized.

3.      After intravenous infusion or oral antibiotics, hormones three days.

Advantage:

1.      Diode laser can be completed the role of vaporization and coagulation at the same time with vocal cords diseases.

2.      Hoarseness disappeared, vocal no adhesion, no trauma, and normal activities.

Notice:

1.      The handpiece should under the guidance of the fiber alignment lesions, that in order to protect the surrounding normal tissue.

2.      Bilateral vocal cord lesions were needed treat a second operation.

Laser Nasal Polyps Treatment

Clinical Application:

Laser Nasal Polyps Treatment

Related Keywords:

Nasal polyps

ENT diode laser treatment

Nasal endoscope surgery

Medical device:

VELAS 810nm 30watt

Power setting:

10--15Watt,  CW

Accessories: 

400um bare fiber, ENT surgery hand piece

Introduction and Operation procedure:

Nasal polyps are growths that result from inflamed mucus membranes in the sinuses and nasal passages. They can extend to the opening of the nostrils, or even down to the throat area. These growths can block the nasal passages.

Nasal polyps are often related to other chronic diseases and tend to last for long periods of time. The majority of people with nasal polyps will experience nasal congestion, which may be severe, that isn't helped by typical allergy medications. Other common symptoms include: Runny nose with clear or colored mucus, Loss or decreased sense of smell and taste, Headache and Sinus pressure.

Put the fibers through ENT hand piece and with the help of nasal endoscope, release the laser to vaporize the polyps, due to good absorption in hemoglobin and water, diode 810 nm laser will offer a better performance in vaporization in tissue as well as stopping bleeding. There is a good sight during surgery and totally no bleeding.

Advantage:

1. Provide clear vision for doctor during the operation, shorten the operation time
2. More precision and safety
3. No harm to the normal tissue when excises the lesion
4. Less blood and pain during and after the operation
5. Enable the patients quickly back to daily life

Notices：

1 Should examine nasal with a nasal endoscope to decide the treat area.

2 Should pay attention to laser emission on surrounding tissues. 

Laser Nasal Polyps Treatment

Clinical Application:

Laser Nasal Polyps Treatment

Related Keywords:

Nasal polyps

ENT diode laser treatment

Nasal endoscope surgery

Medical device:

VELAS 810nm 30watt

Power setting:

10--15Watt,  CW

Accessories: 

400um bare fiber, ENT surgery hand piece

Introduction and Operation procedure:

Nasal polyps are growths that result from inflamed mucus membranes in the sinuses and nasal passages. They can extend to the opening of the nostrils, or even down to the throat area. These growths can block the nasal passages.Nasal polyps are often related to other chronic diseases and tend to last for long periods of time. The majority of people with nasal polyps will experience nasal congestion, which may be severe, that isn't helped by typical allergy medications. Other common symptoms include: Runny nose with clear or colored mucus, Loss or decreased sense of smell and taste, Headache and Sinus pressure.

Put the fibers through ENT hand piece and with the help of nasal endoscope, release the laser to vaporize the polyps, due to good absorption in hemoglobin and water, diode 810 nm laser will offer a better performance in vaporization in tissue as well as stopping bleeding. There is a good sight during surgery and totally no bleeding.

Advantage: 

1. Provide clear vision for doctor during the operation, shorten the operation time
2. More precision and safety
3. No harm to the normal tissue when excises the lesion
4. Less blood and pain during and after the operation
5. Enable the patients quickly back to daily life

Notices： 

1 Should examine nasal with a nasal endoscope to decide the treat area.

2 Should pay attention to laser emission on surrounding tissues.