New Surgical Procedure Could Save Millions -- MEDICA - World Forum for Medicine

The procedure removed growths from the airway of a patient using new technology that allows the surgery to be done in the doctor's office with the patient completely awake, and the patient to go home immediately afterward.

In the past, this surgery required equipment that could be used only in the operating room with the patient under general anaesthesia, and the patient was often required to spend the night in the hospital.

In the new procedure, two different lasers were used: a carbon-dioxide (CO2) laser delivered by a newly developed hollow-core optical fiber, and a pulsed-dye laser delivered by standard solid optical fiber. Each is guided by a high-resolution video-endoscope, and the entire system is delivered to the patient through a tiny tube that is placed in the nose.

The surgery was performed by Jamie Koufman, M.D., professor of surgery-otolaryngology at Wake Forest Baptist and director of the Center for Voice and Swallowing Disorders.

Koufman explained that the two lasers are complementary. The CO2 first removes the growths in the larynx and trachea, and the pulsed-dye laser is then used to treat the base of the growths and help prevent recurrence. Koufman removed recurrent respiratory papillomas.

Koufman said that the same approach will work for 50 to 70 percent of all laryngeal surgeries, including removal of vocal nodules, polyps, cysts, granulomas, and even vascular lesions. For her alone, Koufman said, that represents hundreds of patients a year. It may eventually be used for laryngeal cancer and other endoscopic specialties.

"We're talking about a paradigm shift for laryngeal and airway surgery,” Koufman said. "It's easier, it's cheaper, we do a better job, there's less risk, and we do it here in the office. It's the future of surgery.”; Source: Wake Forest University Baptist Medical Center