Laser Photocoagulation

There are CO2 as well as Neodymium: yttrium aluminium-garnet (Nd: YAG) lasers. Lasers with contact tips are generally referred over free beam lasers. The lasers generate temperatures as high as 2001°C and can produce varying depths of coagulation depending on the type of tip used and the amount of hepatic blood flow at the time of surgery. A broader zone of coagulation, up to 7 to 8 mm, can be achieved by reducing the blood flow through vascular occlusion.29 The main advantage of the laser is that dissection through a tough, cirrhotic liver is much easier and faster. One drawback, however, is that the surgeon cannot identify vessels and biliary structures prior to their division. Some groups have reported higher blood losses with laser, compared with argon beam and ultrasound dissection.30

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