Traditional Scalpel Research Articles

Laser blepharoplasty with transconjunctival orbicularis muscle/septum tightening and periocular skin resurfacing: a safe and advantageous technique.

Carbon dioxide (CO2) laser blepharoplasty with orbicularis oculi muscle tightening and periorbital skin resurfacing is a safe procedure that produces excellent aesthetic results and diminishes the occurrence of complications associated with skin and muscle resection in the lower lid, particularly permanent scleral show and ectropion. The authors present a review of 196 cases of carbon dioxide laser blepharoplasty and periocular laser skin resurfacing performed at their center from April of 1994 to September of 1998. Of these cases, 113 patients underwent four-lid blepharoplasty, 59 underwent upper lid blepharoplasty only, and 24 underwent lower lid blepharoplasty only. Prophylactic lateral canthopexy was performed in 24 patients. Concomitant procedures (brow lift/rhytidectomy/rhinoplasty) were performed in 92 patients. The carbon dioxide laser blepharoplasty procedure resulted in no injuries to the globe, cornea, or eyelashes. Combined with laser tightening of the orbicularis oculi muscle and septum and periocular skin resurfacing, the transconjunctival approach to lower blepharoplasty preserves lower lid skin and muscle. Elimination of the traditional scalpel skin/muscle flap procedure results in a dramatically lower complication rate, particularly with regard to permanent ectropion and scleral show. Laser shrinkage of the orbicularis muscle and septum through the transconjunctival incision enables the correction of muscle aging changes such as orbicularis hypertrophy and malar festoons. The addition of periocular resurfacing enables the correction of skin aging changes of the eyelid that are not addressed by traditional scalpel blepharoplasty. In addition, lateral canthopexy constitutes an important adjunct to the laser blepharoplasty procedure for the correction of lower lid canthal laxity.

Reduced tumor cell transfer with contact neodymium-yttrium-aluminium garnett laser scalpels.

The local recurrence of tumor growth after surgery is thought, in part, to be a consequence of seeding of tumor cells from the primary lesion. This study was directed at determining if the contact Nd:YAG laser provides any advantage over the use of traditional scalpel dissection for tumor resection. Five human tumor tissue culture cell lines were studied in this report. They included MCF-7 (breast), HeLa (cervical), SW-780 (bladder), HT29 (colon), and A549 (lung). Using a scalpel blade or contact laser scalpel (with or without laser energy), the ability to transfer viable cells from dense cell stocks to new tissue culture wells was tested. Using the A549 cell line, the extent that these instruments were able to "seed" tumor cells was also assessed in a soft agar, in vitro, "incision" model. Results from these studies suggest that the contact laser scalpel has a significantly lower potential to transmit tumor cells, when compared to traditional scalpel blades.