Ergonomics

LightScalpel soft tissue CO₂ laser treatment improves surgical field visibility through reduced bleeding. Another contributing factor is the strong airflow from the narrow beam exit aperture (area approx. 0.5 mm²).  The airflow is important because it prevents smoke-like vaporized tissue from obscuring the surgical site. Since the flexible fiber laser’s handpiece is held only 1-3 mm away from the tissue, this airflow is sufficient for maintaining good visibility.

In contrast, the articulated arm’s handpiece is held 2 – 3 cm away from the tissue, which is 10 times farther than the distance to tissue for the flexible fiber CO₂ laser. In addition, the beam exit aperture of the articulated arm laser is large (area approx. 100 mm²). The large distance and size make the air-purge in articulated arm lasers ineffective and result in reduced visibility of the surgical field.

The flexible fiber CO₂ laser handpiece is held very close to the tissue, i.e. it is aimed at a distance of 1 – 3 mm, allowing the surgeon to gain maximum stability by resting the hand holding the handpiece on the patient during the medical or dental laser treatment. Such positioning means that flexible fiber CO₂ lasers are well suited for a wide variety of procedures including high precision ones. Articulated arm delivery handpieces are held 2 – 3 cm from the tissue; this results in lower precision and necessitates a visible aiming beam which is inaccurate (greatly exceeds the diameter of the laser beam) and obscures the surgical site visibility. Articulated arm lasers are suitable for simple skin incisions and gross dissection, but are ineffective for higher precision cosmetic, medical or dental laser treatments.

LightScalpel flexible fiber CO₂ lasers can be used with multiple sizes of focusing tips and tipless nozzles that can be quickly and easily changed during medical or dental laser treatment: 0.25, 0.4, 0.8, and 1.4 mm. This variety of spot sizes enables the surgeon to choose the size that is most appropriate for the procedure and type of target soft tissue. Articulated arm lasers offer one fixed focal spot size, usually 0.2 – 0.25 mm.

Cutting and removing tissue requires maximum power density. However, hemostasis and wound contraction are achieved with lower power density. Flexible fiber CO₂ laser focusing tips with a focal length of 1 – 3 mm produce a laser beam with wide angles of convergence and divergence. This enables the surgeon to adjust power density by just moving the handpiece away from the tissue. The focusing lens used in articulated arm laser handpieces has a fixed, 50 – 100 mm focal length. The angles of convergence and divergence of their laser beam are very narrow; therefore, it is only possible to defocus the beam by holding the handpiece far from the tissue.

Flexible fiber CO₂ laser focusing tips have a wide-angle of divergence, which, along with rapid defocusing of the beam, means that the danger zone for eye injury is relatively short. The nominal hazard zone is far longer for articulated arm lasers because, due to the narrow-angle of divergence of their focusing lens system, the laser beam maintains high power density for a great distance.

Articulated arm lasers require a visible aiming beam since the surgeon must hold the handpiece away from the tissue for the laser beam to focus – the visible aiming beam is the only visible indicator of where the focused CO₂ laser beam will hit the target. Even the slightest misalignment between the aiming beam and CO₂ beam results in great collateral damage, causing the laser beam to hit unintended areas around the target.

Flexible fiber CO₂ lasers have a special external calibration feature, which allows the clinician to accurately verify whether the selected power setting is actually exiting the delivery system. In articulated arm lasers, however, the energy entering the delivery system is monitored by an internal power meter, but there is no way to verify the energy exiting the system is attenuated within the aging delivery system.

Fine print instructions in articulated arm laser user manuals call for annual calibrations of the beam delivery; these can only be done by a visiting field service engineer, at the expense of the articulated arm laser owner. However, flexible fiber CO₂ laser owners can perform calibrations daily for ultimate accuracy and precision, all due to distal end calibration built into flexible fiber CO₂ lasers – at no cost to the owner.

The use of flexible fiber CO₂ lasers, with their pen-shaped light handpieces, is intuitive due to their scalpel-like feel. Clinicians who perform medical or dental laser treatment in hard-to-reach areas particularly value the ease of access provided by the flexible fiber surgical CO₂ laser. The short learning curve, along with the ease of use, explains the growing popularity of flexible fiber CO₂ lasers.

Articulated arm lasers are more expensive and far less ergonomic; they have limited applications and require longer time for return on investment.

The return on investment for the flexible fiber surgical CO₂ laser is fast and substantial because of its versatility for virtually all types of soft-tissue surgeries, lower cost of ownership and longevity.