Lasers in Neurosurgery

Some will The application of this new energy form in remember those who argued that the magnifica­ tandem with the surgical microscope has, in my tion and illumination provided by the micro­ opinion, extended the scope of all aspects of scope were not valuable to the skilled surgeon neurosurgery.

Developments in the field of instrumentation of innovative instrumentation. Although laser applications have permeated nearly every aspect are among the major contributions to human advancement. The history of surgery has seen of surgical therapy, the expectations have fre­ many revolutionary developments cause quantum quently been unrealistic and the evaluation of leaps in progress. Electrocautery, the anesthesia technological development has always been machine, computed axial tomography, and the painfully slow. The properties of vaporization, surgical microscope are all revolutionary in­ coagulation, and cutting unified in an invisible struments that have irrevocably changed the shaft of light have enabled the neurosurgeon to direction of neurological surgery. vaporize inaccessible tumors of brain and spinal In the early stages of application, there are cord, harness recalcitrant bleeding sites, and cut always detractors and valid controversy concern­ through the most formidable calcified tumors. ing the value of a new instrument. Some will The application of this new energy form in remember those who argued that the magnifica­ tandem with the surgical microscope has, in my tion and illumination provided by the micro­ opinion, extended the scope of all aspects of scope were not valuable to the skilled surgeon neurosurgery. We have much more work to do. and would prolong the operative time and in­ lt is necessary to document improved results and crease infection rates. Others may recall that demand technological advances and safe inno­ Cushing was told to abandon the blood pressure vations.