ENT Laser Surgery

Transoral Laser Microsurgery

CO2 Lasers have revolutionized the way otolaryngologists approach surgery, enabling highly precise and, often, less invasive treatment of a wide range of Head & Neck applications.
Unlike open surgery, CO2 lasers can remove cancer with fewer disturbances to structures, nerves, and tissue.

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CO₂ Laser Technology for ENT

Lumenis’ advanced laser systems enable highly controlled, smart tissue managment for treating delicate anatomy and preservation of healthy tissue.

Lumenis’ CO₂ technology is associated with clean margins which is one of the most valuable objectives for pathology and malignant surgical procedures as well as patient healing process.

Surgical approach – Transoral Laser Microsurgery

TLM -Transoral laser microsurgery is the most used acronym for CO₂ laser endoscopic transoral surgery of the pharynx using the CO₂ laser. Lumenis CO₂laser TLM procedure is a synonym for precision. The term TLM is not limited to rigid surgical approach. It also represents flexibility. Surgical approach where compliance to flexible endoscopy and robotic surgery is possible and treating precisely on hard to reach anatomy is achievable.

“ TLM is superior to radiotherapy which is often an over-treatment. Oncological results are often better with laser surgery than with radiation. In my experience, there is less local recurrence, and less salvage laryngectomies. Morbidity and complication rates are lower with similar results.“

Wolfgang Steiner, M.D. Professor Emeritus, Department of Otolaryngology University of Gottingen Medical Center, Germany

TLM as first line treatment

The use of chemotherapy, radiation therapy, or cold knife surgery in the treatment of transoral airway cancer may be associated with complications that can dramatically alter facial appearance.
Due to the delicacy and minimally invasive operative method, CO₂ lasers are increasingly becoming a first line treatment of early stage airway cancers, especially in the larynx. Studies have demonstrated considerable cost savings and equivalent or better treatment outcomes for transoral laser resection of laryngeal tumors in comparison to radiation.¹

TLM Advantages:

Precise incision, excision, and vaporization, with microvascular hemostasis
Predictable, reproducible laser-tissue interaction
Minimal thermal damage for excellent tissue margins
Minimal disturbance to structures, nerves, and tissue
Multi-option salvage treatments in the event of recurrence
Smart margin management and minimal healthy tissue loss
Suture-free procedure enables swallowing sooner post-surgery

Clinical Indications

Studies have shown that compared with other types of lasers and treatment modalities, Physicians using CO₂ lasers for ear surgery can attain superior outcomes (1,2,3).

The Lumenis CO₂ laser solutions are uniquely designed to provide diverse treatment options in the operating room or the outpatient setting, under local or complete anesthesia. Partial list of approved indications for use includes: Stapedotomy, Acoustic Neuroma, Cholesteatoma, Eustachian tube dysfunction, Polyps and granulation tissue in external ear canal, Otitis media, Congenital aural atresia, Otosclerosis, Revision stapedotomy, Cochlear implant revision.

Lumenis Delicate Otology Solutions

OtoLase^™

Complete visualization and surgical control

OtoLase is the latest innovation of flexible CO₂ laser middle ear surgery. The microsurgical precision of the OtoLase delivery system makes it the ideal tool for delicate middle ear surgery and adequate treatment for small and sensitive auditory structures. With OtoLase, surgeons can expect new levels of precision, ease-of-use, durability and cost-effectiveness.

OtoLase™ Unique features:

Flexibility and Ease of Use: The multi-use straight and bent handpieces are designed with a grasping mechanism for simple maneuvering and optimal ergonomics.
Complete Visualization: The handpiece, shaft and tip are designed to facilitate an effective operational field.
Precision in Fenestration: As ensured by the use of a small spot size and ultra-thin, highly durable tip.
Predictable Tissue Interaction: Delicate layer-by-layer tissue removal with minimal thermal spread.
Maximal Versatility: With interchangeable handpieces and single use straight and bent tips.

“The OtoLase has been ergonomically engineered to meet the surgical needs. The air flow system eliminates the laser plume and facilitates visualization, and the aiming beam ensures target accuracy. The low profile and thin design allows the surgeon to reach the smallest recesses within the middle ear. This enhanced fiberoptic CO2 laser technology has been worth the wait.”

John T. McElveen, Jr., M.D, Carolina Ear & Hearing Clinic, Raleigh, N.C., USA

MicroLase^™

Extending Precision to Your Fingertips

Collaborating closely with leading physicians, Lumenis developed the MicroLase™ Otology Set -a comprehensive Otology solution. The solution includes two unique, single-use handpieces, for easy access to all parts of the ear, and an advanced reusable MicroLase fiber. The MicroLase™ Otology solution is designed to expand the use of the AcuPulse™ DUO and AcuPulse™ 40WG CO₂ laser systems for ear surgery, enabling the surgeon to attain the desired tissue effect and perform highly complex Otology surgeries to perfection.

MicroLase^™ Unique features:

25 Procedures: That can be performed with the same 2m long fiber. A price sensitive solution that meets your required treatment costs
Small Shaft: Assures visibility and complex movements throughout the challenging auditory structures
Controlled Tissue Management: Adjustable laser parameters to control power settings, exposure duration and distance from tissue
Easy set up: The single-use handpieces are provided sterile for smooth operation in the operating room

Marchese, M.R., et al., “One-shot” CO₂ versus Er:YAG laser stapedotomy: is the outcome the same? Eur Arch Otorhinolaryngol, 2011. 268(3): p. 351-6.
Lesinski SG, Lasers for otosclerosis–which one if any and why, Lasers Surg Med. 1990;10(5):448-57.
Motta, G. and L. Moscillo, Functional results in stapedotomy with and without CO₂ laser. ORL J Otorhinolaryngol Relat Spec, 2002. 64(5): p. 307-10.