Use of Lasers in Equine Upper Airway Surgery

Introduction
Lasers are used in equine general surgery to incise, vaporize or coagulate tissue with minimal hemorrhage and reduced surgical morbidity to the patient. Although there are numerous wavelengths available, the two most common lasers originally used in veterinary surgery were the carbon dioxide (CO2) and the neodymiumiyttrium aluminum and garnet (Nd:YAG) lasers. The wavelengths of these two lasers have complimentary photobiologic properties and can be used to accomplish a variety of surgical procedures in horses. Approximately ten years ago the GaAlAs diode laser system was introduced to the veterinary surgery market. This laser has a wavelength and clinical properties that are quite similar to that of the Nd:YAG laser. With its solid state electronics, compact design, portability and economic price, the GaAlAs diode laser has largely replaced the Nd:YAG laser in most equine hospitals and specialty practices. The holmium laser and the pulsed dye laser also may be used for selecterd equine applications. Because of their reliable and predictable tissue effects and their ability to use a flexible fiberoptic delivery system for transmission of laser energy to tissue, the NdYAG and GaAlAs diode lasers are the most appropriate wavelengths for trans-endoscopic use in the upper airway of the horse. For reasons stated earlier, the GaAlAs diode laser is currently the laser of choice for most equine clinics throughout the world. Although hollow waveguides are commercially available for use with the CO2 laser, their energy output is limited. From a practical standpoint, this limits the effective use of the CO2 laser within the upper airway to “line of sight” applications through a ventral laryngotomy incision.  [...]