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At least 505 records · Page 28Linked to original sources
PubMed1984

Tubal patency and pelvic adhesions at early second-look laparoscopy following intraabdominal use of the carbon dioxide laser: initial report of the intraabdominal laser study group.

It has been suggested that the carbon dioxide (CO2) laser, by virtue of its hypothetical capabilities for precise incisions, minimization of tissue handling and bleeding, and shortened operating time, may improve the success rate of gynecologic infertility surgery. To assess this hypothesis, a multicenter prospective study was performed to assess tubal patency and adhesion formation at early second-look laparoscopy after intraabdominal laser surgery. Procedures performed included salpingoneostomy, fimbrioplasty, lysis of adhesions, vaporization of endometriosis, and ovarian wedge resection. The results were compared with those of another multicenter prospective study that utilized nonlaser reconstructive pelvic surgery. Use of the CO2 laser was found to result in a greater tubal patency rate at the time of the second-look procedure. Adhesions present at the time of the second-look procedure were reduced from initial presentation at most sites; however, nonlaser infertility surgery appeared to have equal or greater efficacy in the prevention of adhesion formation at most sites. Thus, the CO2 laser does not appear to be a panacea for the treatment of tuboperitoneal causes of infertility. Pregnancy rates following intraabdominal use of the CO2 laser remain to be established.

Adolescent↗
PubMed1995

Endoscopic intracorporeal laser lithotripsy of difficult common bile duct stones with a stone-recognition pulsed dye laser system.

BACKGROUND: Endoscopic retrograde intracorporeal lithotripsy with a stone recognition laser system seems to be a promising alternative in patients with difficult bile duct stones. METHOD: Sixteen patients with bile duct stones not suitable for endoscopic standard procedures underwent intracorporeal laser lithotripsy during a 3-month period. An average of 6800 (120 to 25000) discharges were applied with a power setting of 100 mJ. Inserting the laser fiber into a radiopaque marked catheter or into a balloon catheter guaranteed a successful location on the stone surface in 70% of all discharges. The automatic feedback/cut-off at the fiber is not in contact with the stone surface. RESULTS: Fragmentation was achieved in all cases. Complete bile duct clearance was reached in 14/16 cases. In two cases, remaining fragments passed spontaneously through the papilla as controlled by ERCP. Minor complications were noted in two patients (hemobilia, cholangitis). Complete recovery was achieved in both patients with conservative management. CONCLUSIONS: For a selected group of patients with difficult common bile duct stones, intracorporeal laser lithotripsy with a stone recognition laser system was found to be a highly effective and safe technique.

Aged↗
PubMed2000

Laser in situ keratomileusis for high myopia with the VISX star laser.

PURPOSE: To evaluate the results of laser in situ keratomileusis (LASIK) for spherical and spherocylindrical myopia (range, 9-22 diopters [D]) with the VISX Star laser, (VISX Inc., Santa Clara, CA). DESIGN: Non-comparative, single-surgeon interventional case series. PARTICIPANTS: Two hundred ninety eyes of 175 patients. METHODS: Consecutive patients who underwent LASIK in the study range with the VISX Star laser were evaluated for early (approximately 1 month) and late (after 9 months) outcomes. Both single procedure outcomes and results after reoperation for refractive enhancement were included. MAIN OUTCOME MEASURES: Outcome measures included uncorrected visual acuity, manifest refraction, refractive predictability, refractive stability, best spectacle-corrected visual acuity (BSCVA), results of reoperations, and complications. RESULTS: At the early postoperative examination, approximately 1 month after surgery, 285 of 290 eyes (98.3%) were examined. Uncorrected visual acuity of 20/40 or better occurred in 209 of 285 (73.3%) eyes, and 198 of 285 (69.5%) eyes had a manifest spheroequivalent between +/-1.00 D. Subsequently, 60 eyes (20.7%) underwent reoperation for refractive enhancement. Late results, beyond 8 months from the initial surgery and including reoperations, were available in 195 of 290 eyes (67.2%). Uncorrected visual acuity results of 20/40 or better were found in 166 of 195 eyes (85.1%) and of 20/25 or better in 99 of 195 eyes (50.8%). Manifest spheroequivalent results were +/-2.00 D in 187 of 195 eyes (95.9%) and +/-1.00 D in 148 of 195 eyes (75.9%). In a paired-cohort analysis of 131 single-procedure eyes seen at both intervals, refractive stability (change in manifest refractive spheroequivalent of less than 1.00 D) was present in 101 of 131 eyes (77.1%) between the two observation intervals. Overall, approximately 3.6% eyes lost 2 lines or more of BSCVA, and other complications (flap wrinkling and epithelial ingrowth) were reported in 2% of eyes. Improvement in BSCVA of 1 line or more occurred in 5.6% eyes. CONCLUSIONS: Laser in situ keratomileusis for high myopia with the VISX Star laser provided satisfactory refractive and visual results that compare well with other reports in the literature. Subjective results and other measures of visual function need further evaluation.

Adult↗
PubMed2002

Laser in situ keratomileusis for myopia and compound myopic astigmatism using the Technolas 217 scanning-spot laser.

PURPOSE: To evaluate the safety, efficacy, predictability, and visual results of laser in situ keratomileusis (LASIK) using the Bausch & Lomb Technolas(R) 217 scanning-spot laser for the treatment of myopia and compound myopic astigmatism. SETTING: Stanford Eye Laser Center, Stanford, California, USA. METHODS: In a prospective study, 110 eyes of 58 patients with a mean spherical equivalent (SE) of -4.87 diopters (D) +/- 2.5 (SD) (range -1.0 to -11.4 D) had LASIK for myopia and compound myopic astigmatism using the Technolas 217 scanning-spot laser. The primary outcome variables included preoperative and postoperative best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), achieved versus attempted correction, vector analysis of astigmatism, and complications. RESULTS: One hundred ten eyes were available for analysis at 3 months. The mean SE refraction was reduced 95% (mean -0.23 +/- 0.4 D), and astigmatism was reduced 70% (mean 0.28 +/- 0.3 D). One day postoperatively, 100% of eyes had a UCVA of 20/40 or better, 96% had 20/25 or better, 77% had 20/20 or better, and 39% had 20/15 or better. At the 3-month examination, 100% of eyes had a UCVA of 20/40 or better, 95% had 20/25 or better, 83% had 20/20 or better, and 48% had 20/15 or better. Ninety percent of eyes were within +/-0.5 D of emmetropia. No eye lost 2 or more lines of BSCVA. CONCLUSIONS: The Technolas 217 scanning-spot laser produced excellent postoperative UCVA and BSCVA. It was predictable, safe, and effective for the treatment of myopia and compound myopic astigmatism. Long-term follow-up is needed to assess the stability of the procedure.

Adult↗
PubMed1999

Laser in situ keratomileus using the LaserSight 200 laser: results of 950 consecutive cases.

PURPOSE: To examine the refractive outcome in 950 consecutive eyes having laser in situ keratomileusis (LASIK) by 1 surgeon with experience in keratomileusis. SETTING: Outpatient excimer laser surgical facility. METHODS: This study comprised 950 consecutive eyes of 475 patients having LASIK as a primary procedure with a LaserSight 200 excimer laser (8.51 software). A nasal hinged flap and a Chiron microkeratome were used. Preoperative cycloplegic refraction was done only in patients younger than 25 years and in all hyperopic cases. Subjective preoperative and postoperative manifest refractions were done after autorefractometry in all cases. In cases of hyperopia, the software was modified by adding 30% to the refractive error. Enhancement results are not included. RESULTS: Of the 950 eyes, 893 (94.00%) were myopic and 57 (6.00%), hyperopic. In the low myopia group (1.00 to 3.99 D) of 223 eyes (24.97%), mean spherical equivalents (SEs) were -2.90 D +/- 0.56 (SD) preoperatively, -0.46 +/- 0.6 D 3 months postoperatively, and -0.41 +/- 0.5 D 6 months postoperatively. In the moderate myopia group (4.00 to 5.99 D) of 205 eyes (22.96%), respective mean SEs were -4.90 +/- 0.7 D, -0.90 D +/- 0.9 D, and -0.67 +/- 0.7 D. In the high myopia group (6.00 to 9.99) of 266 eyes (25.30%), the respective means were -7.70 +/- 1.3 D, -0.76 +/- 0.99 D, and -0.60 +/- 0.8 D. In the extreme myopia group (10.21 to 30.00) of 199 eyes (22.28%), the respective means were -13.30 +/- 2.9 D, -1.30 +/- 1.4 D, and -1.13 +/- 1.3 D. For the entire myopic group, the mean astigmatism was +1.55 +/- 1.38 D, +1.09 +/- 0.92 D, and +0.87 +/- 0.77 D, respectively. The low hyperopia group (1.00 to 2.99 D) of 39 eyes (68.42%) had a mean preoperative SE of +1.80 +/- 0.59 D and mean postoperative SEs of +1.00 +/- 0.76 D at 3 months and +1.16 +/- 0.52 D at 6 months. The respective means in the moderate hyperopia group (3.00 to 6.00) of 18 eyes (31.57%) were +4.62 +/- 1.19 D, +3.71 +/- 1.12 D, and +4.00 +/- 1.07 D. CONCLUSIONS: Laser in situ keratomileus for myopia using the LaserSight 200 excimer laser was stable with time and safe for the correction of different degrees of myopia. In the hyperopic group, marked regression occurred in a large percentage of patients. Thus, we will not perform LASIK for hyperopia until the software improves.

Adult↗
PubMed1999

Clinical experience with the holmium:YAG laser for transmyocardial laser revascularization and myocardial denervation as a mechanism.

Transmyocardial laser revascularization is emerging as a treatment option for patients with debilitating angina pectoris and no conventional treatment option. Results with the high powered CO2 laser have been reproducibly encouraging. As the mechanism of action remains uncertain, the importance of the type of laser used is unknown. Interest in developing less invasive approaches, ultimately including catheter-based technologies, has stimulated the evaluation of alternative laser energy sources with fiberoptic delivery systems. One such device is the holmium:YAG laser. Clinical experience with the holmium:YAG-based systems is still in its early stages. We review our experience with one such device and the existing literature on the subject. We also briefly describe experimental evidence that this device is capable of denervating the heart locally.

Angina Pectoris↗
PubMed2004

Treatment of xanthelasma palpebrarum with argon laser photocoagulation. Argon laser and xanthelasma palpebrarum.

PURPOSE: We report the results of argon laser coagulation of xanthelasma lesions. METHODS: Forty eyelids of 24 patients with xanthelasma were treated in 1 to 4 sessions at 2-3 week intervals, using an argon green laser. The laser parameters were as follows: wavelength 514 nm; spot size 500 microns; energy 900 mW; the duration of the laser pulse 0.1-0.2 seconds. The procedure was done on outpatient basis. A gauze pad soaked in topical anaesthetic eye drops was applied to the surface of the lesion. RESULTS: The therapy was well tolerated, and all lesions responded to the therapy. There were no complications and no functionally relevant scar developed. The cosmetic outcome was considered to be good in 85% of the cases. CONCLUSION: Argon laser photocoagulation represents an alternative treatment in selected cases. It is easy to perform and well tolerated by the patients.

Adult↗
PubMed2001

Laser hair removal: long-term results with a 755 nm alexandrite laser.

BACKGROUND: Hypertrichosis is a common problem for which laser hair removal is becoming the treatment of choice. Optimal wavelength, pulse duration, spot size, fluence, and skin cooling parameters for various skin types have not yet been firmly established. OBJECTIVE: To evaluate the long-term efficacy and safety of a 3-msec 755 nm alexandrite laser equipped with a cryogen cooling device for patients with Fitzpatrick skin types I-V. METHODS: Eighty-nine untanned patients with skin types I-V underwent a total of 492 treatments of laser hair removal over a 15-month period. Each patient in the study underwent a minimum of three treatment sessions spaced 4-6 weeks apart (mean treatments 5.6). Retrospective chart review and patient interviews were used to establish hair reduction results. Treatment sites included the axillae, bikini, extremities, face, and trunk. A 3-msec pulse width, 755 nm alexandrite laser equipped with a cryogen spray cooling device was used in this study. Spot sizes of 10-15 mm were used. A spot size of 10 mm was used for fluences greater than 40 J/cm(2), a spot size of 12 mm was used for fluences of 35-40 J/cm(2), and spot sizes of 12 and 15 mm were used for fluences less than 30 J/cm(2). Fluences ranging from 20 to 50 J/cm(2) (mean fluence 36 J/cm(2)) were used. RESULTS: The patients had a mean 74% hair reduction. Skin type I patients had an average of 78.5% hair reduction using a mean fluence of 40 J/cm(2) (35-50 J/cm(2)) and a 10-12 mm spot size (12 mm in more than 95% of treatments). Skin type II patients had a mean 74.3% hair reduction using a mean fluence of 38 J/cm(2) (30-40 J/cm2) and a 12-15 mm spot size. Skin type III patients had a mean 73.4% hair reduction using a mean fluence of 37 J/cm(2) (25-40 J/cm(2)) and a 12-15 mm spot size. Skin type IV patients had a mean 71.0% hair reduction using a mean fluence of 31 J/cm2 (25-35 J/cm(2)) and a 12-15 mm spot size. A patient with skin type V had a 60% hair reduction using a mean fluence of 23 J/cm(2) (20-25 J/cm(2)) and a 12-15 mm spot size. The efficiency of hair removal directly correlates significantly with the fluence used. Rare side effects included transient postinflammatory hyperpigmentation (n = 9; 10%), burn with blisters (n = 1; 1%), and postinflammatory hypopigmentation (n = 2; 2%). All complications resolved without permanent scarring. CONCLUSION: The 3-msec cryogen cooling-equipped alexandrite laser can safely and effectively achieve long-term hair removal in patients with skin types I-V. The best results are achieved in untanned patients with skin types I-IV.

Female↗
PubMed2002

Determination of optimal parameters for laser for nonablative remodeling with a 1.54 microm Er:glass laser: a dose-response study.

BACKGROUND: Nonablative subsurface heating is a challenge for medical laser companies. Among the different lasers proposed today, the erbium-glass (Er:glass) laser combined with contact cooling could be an alternative for nonablative remodeling. OBJECTIVE: To investigate the risk of side effects according to the quality of cooling and number of pulses. METHODS: A clinical evaluation was performed on 10 patients using an Er:glass laser (1.54 microm) with contact sapphire cooling handpiece (+5 degrees C). Periorbital and perioral areas were treated with a number of pulses increasing gradually from three to eight for a total energy of 24-64 J/cm2. The presence or absence of swelling, crust, blister, and erythema were graded at 7 days. At 3 months postoperatively, hypopigmentation, hyperpigmentation, textural changes, and scars were evaluated clinically. RESULTS: Periorbital and perioral areas respond differently to the number of pulses defining a "safe" clinical threshold. The periorbital site is very sensitive to dermal heating and efficacy of contact cooling; the anatomic features of this body location may explain these differences. CONCLUSION: Selective dermal heating can be achieved with an Er:glass laser coupled with a contact cooling handpiece. The quality of the contact cooling and the number of pulses appear to be important parameters for safety and reproducible clinical results.

Adult↗
PubMed1986

Laser-induced vascular lesions by cw-NdYAG or pulsed UV lasers during angioplastic procedures.

Conventional (NdYAG, Argon and CO2 lasers) laser and pulsed far ultraviolet laser radiation are able to remove arteriosclerotic tissue of the arterial wall. However, there is a striking difference between both systems: The continuous wave of conventional wave-length laser-radiation produces considerable thermal injury to the surrounding tissue, whereas the effect of pulsed far ultraviolet radiation induces less or no thermal damage despite an easily assessable tissue-removing effect. In the following study the potential of far UV laser-radiation for recanalization of occluded vessels is demonstrated in in-vitro experiments on fresh and well preserved atherosclerotic human vessels.

Animals↗
PubMed1995

[Special suction tube holder for a laser handpiece in effective smoke suction evacuation. On the problem of smoke suction in external CO2 laser therapy].

Treatment with a CO2 laser causes high smoke production, which leads to reduced view to the surgical field, to bad smell and has potential health hazards. Hitherto the problem of the external smoke evacuation had not been solved sufficiently. Therefore a special sucking-tube holder for a laser handpiece is presented. The end of the sucking tube exactly follows all movements of the handpiece and can be positioned close to the source of smoke. Through a defined angle the smoke can be removed quickly out of the way of the laser beam. According to the practical experiences so far, this special equipment on a laser handpiece guarantees an effective evacuation of smoke, allows the reduction of assisting staff, reduces irritation through bad smell and additionally minimizes the potential risks of smoke caused by an external CO2 laser application.

Condylomata Acuminata↗
PubMed2000

Elucidating the pulsed-dye laser treatment of sebaceous hyperplasia in vivo with real-time confocal scanning laser microscopy.

BACKGROUND: Several case reports document successful treatment of sebaceous hyperplasia with the pulsed-dye laser. Moreover, noninvasive real-time confocal laser scanning microscopy elucidates the vascular nature of these lesions and their pathophysiologic response to treatment mediated by vessel coagulation. METHODS: Ten patients with 29 lesions of sebaceous hyperplasia were treated with 3 stacked 5-mm pulses of the 585-nm pulsed-dye laser at fluences of 7 or 7.5 J/cm(2). Confocal imaging was performed before and immediately after treatment, as well as at 2, 4, and 8 weeks of follow-up. RESULTS: The great majority of lesions responded to one treatment, with complete disappearance in 28%, decrease in diameter in 66%, and flattening in 93%. Although 28% recrudesced after initial involution, only 7% recurred completely. Three lesions became eroded or crusted, and 7 experienced cutaneous depressions before complete healing, but no scarring or pigmentary side effects were noted. Confocal imaging revealed a prominent "crown" of blood vessels surrounding the sebaceous duct and coagulation of these vessels with pulsed-dye laser treatment. However, the vessels reappeared during follow-up, and no noticeable morphologic changes in the sebaceous duct were noted. CONCLUSION: Vascular targeting of sebaceous hyperplasia can be monitored with real-time reflectance confocal microscopy. Most sebaceous hyperplasia regresses after one treatment with 3 stacked pulses of the 585-nm pulsed-dye laser. Whether this response is due to temporary ischemia induced by selective vessel destruction or nonspecific thermal diffusion beyond the vessels from pulse stacking has not been determined.

Adult↗
PubMed1987

Argon laser angioplasty with a laser probe.

A preliminary basic study of argon laser angioplasty with the use of a specially designed probe is presented. Arterial specimens were harvested from 10 amputated lower extremities. The studies included the evaluation of coaxial laser angioplasty in 10 partially or totally occluded arteries; the observation of the effect of perpendicularly applied laser energy on 35 thrombi, 54 soft and 10 hard atherosclerotic, and 51 normal arterial walls; the comparison of laser energy requirements for coaxial vessel lumen enlargement or recanalization vs. perpendicular penetration in 10 occluded, hard atherosclerotic arteries; and the spectrographic analysis of calcium density gradient in two specimens. The results showed that the power required for vessel lumen enlargement was 10 +/- 6 J/mm of atherosclerotic vessel (mean +/- standard deviation). The probe followed the original arterial lumen, did not perforate the vessel wall, and created a smooth, enlarged path. The power required to penetrate perpendicularly to a similar depth for thrombi, soft and hard atherosclerotic plaques, and normal arterial walls was 15 +/- 4, 30 +/- 15, 65 +/- 32, and 246 +/- 123 J/mm, respectively. In the hard calcified specimens, laser energy required for coaxial lumen enlargement or recanalization was significantly less than that for perpendicular penetration (p less than 0.05), which correlated with the calcium density map indicating an increase from inside to outside.

Arterial Occlusive Diseases↗
PubMedDate not supplied

Evolution of retinal laser therapy: minimum intensity photocoagulation (MIP). Can the laser heal the retina without harming it?

Laser photocoagulation is a photo-thermal therapy validated by landmark studies and commonly accepted as the standard of care for various retinal diseases. Although its mechanism of action is still not completely understood, it is normally administered with visible endpoints, true intra-retinal burns that cause chorioretinal scars, which, with time, evolve into expanding areas of atrophy. New hypotheses on the mechanism of action of laser photocoagulation suggest that its therapeutic benefits derive from biologic activities that cannot be inducted within the "burned" area of photocoagulation necrosis, but that occur in the adjacent surrounding areas affected by a lower, sub-lethal, photo-thermal elevation. Thus, the iatrogenic chorioretinal damage caused by visible endpoint photocoagulation may be redundant and an equally effective laser therapy could be administered with minimum intensity photocoagulation (MIP) using laser protocols aiming to create only non-lethal photo-thermal elevations with no intraoperative visible endpoint. It is the purpose of this paper to review laser techniques and clinical protocols that have been utilized to administer retina-sparing MIP treatments that hold the promise of healing the retina while minimizing the iatrogenic harm.

Clinical Trials as Topic↗
PubMed2003

Comparative study on a single treatment response to long pulse Nd:YAG lasers and intense pulse light therapy for hair removal on skin type IV to VI--is longer wavelengths lasers preferred over shorter wavelengths lights for assisted hair removal.

OBJECTIVE: To investigate the safety and effectiveness of a long pulsed Nd:YAG (1064nm) laser compared to a shorter wavelength intense pulse light system for assisted hair removal in volunteers with skin type 1V, V and VI. METHODS: Eleven patients of Fitzpatrick skin type IV-VI were recruited into the study. The area treated included the face (upper lips, chin and jaw area), axillae and legs. One half of the body was treated with the long pulse Nd:YAG laser and the other half was treated with the IPL system randomly under topical anesthesia. Degree of pain experienced during treatment, the treatment outcome and any complications were observed. Patients were reviewed at 2 weeks and 6 weeks post-treatment. RESULTS: Volunteers generally described pain from the IPL system as "prolonged burning sensation" but tolerable. Pain from Nd:YAG laser treatment was described as "pinprick" and more intense but tolerable. "Slowing of hair growth"was reported with IPL and Nd:YAG, but with a greater effect from Nd:YAG. Sixty-four percent and 73%(8/11) noticed hair reduction <20% after 6 weeks on IPL and Nd:YAG treated side respectively (ns). Post-inflammatory pigmentation occurred in some volunteers on the IPL treated sides whereas this was not seen on any Nd:YAG treated side, and three of these patients experienced blistering, followed by post-inflammatory pigmentation. CONCLUSION: In our experience the long pulse width 1064 nm Nd:YAG laser, which can penetrate 5-7 mm into the dermis depths to reach the whole length of the hair follicle, would be expected to produce sufficient follicular injury with less epidermal damage in patients with darker skin type compared to shorter wavelength laser and light system.

Adult↗
PubMed2006

Laser skin resurfacing with a novel portable erbium:YAG laser.

BACKGROUND AND OBJECTIVE: The erbium:YAG laser is a popular modality for laser skin resurfacing (LSR). This study was performed to evaluate the safety and efficacy of a new portable Er:YAG laser in the treatment of photo-damaged skin. METHODS: Nine patients with skin types I-III were treated for rhytides, large pores, pigmented lesions, lentigines and photo-damage. Small facial areas such as the periorbital area, nose, cheeks, and upper lip were treated with one to six passes at 5-6 J/cm2 with a new portable Er:YAG laser. Topical and local anesthesia was used. RESULTS: All treated areas showed improvement and, depending upon the number of passes, re-epithelialization was complete within 2-7 days. The intense erythema resolved within 7 days and there was blending of treated and untreated areas within 2 weeks. CONCLUSION: The technique of applying a tailored number of 5-6 J/cm2, 300 micros pulses of a new portable Er:YAG laser to small areas appears to be safe and effective. There was minimal discomfort and a high level of patient satisfaction after a relatively short recovery time.

Adult↗
PubMed1976

Calculation of retinal temperature distributions resulting from laser irradiation of the eye: I. Continuous lasers.

The paper develops a simple analytic expression for the maximum temperature rise attained in the retina as a function of laser power, exposure duration, retinal absorption parameters and image radius. It is assumed that the laser beam has a Gaussian intensity distribution and is absorbed, following Beer's law, in both the pigment epithelium and the choroid layers of the eye. The final expression is mathematically accurate to 1% and is valid for image radii ranging from 20 to 500 mum and for exposure times from 30 ms to infinity. Consequently, this analysis is ideally suited to the interpretation of laser threshold damage experiments using shuttered gas lasers operated in their uniphase mode. Finally, the problem of defining a safe exposure level to laser radiation is considered. However, the lack of available information on minimum retinal image diameter and maximum absorption coefficient permits only an estimate of this parameter to be made.

Lasers↗
PubMed1992

Laser education, laser usage, and surgical attitudes: a challenge for the future.

The results of a questionnaire distributed to enrollees at laser training programs at the Rochester General Hospital between 1986 and 1989 were compared with the results of a previous survey and current patterns of laser utilization and acceptance among surgical house staff. Laser utilization has improved slightly. However, both house staff and attending surgeons prefer, and are most comfortable with, nonlaser technology. Continued efforts to enhance the utilization of laser technology and the availability of laser education at teaching hospitals are key for the future.

Attitude of Health Personnel↗