CO2 laser surgery vs. Traditional surgery

Dr. Ernie Ward

It was around 1998 when I first became interested in CO2 laser surgery. I had returned from a surgical lecture presented by a university professor friend. During his presentation, he casually mentioned his school had recently purchased a human surgical laser. They had begun using it on a variety on cases, especially oral tumors, and were pleased with the results so far. I called him the following week and he offered some advice on the different types of lasers, basic wattage and wavelength theory, and the types of patients he felt benefited most. Within a few months, I had bought my first surgical laser and become a convert. Veterinary CO2 laser surgery can have significant advantages over traditional surgical methods using stainless steel blades. But first, what exactly is laser surgery? 

That's me performing C02 laser surgery on a patient

That's me performing C02 laser surgery on a patient

LASER is an acronym for “Light Amplification by Stimulated Emission Radiation.” In short, a surgical laser is a device that generates a beam of light energy at a specific wavelength. The first surgical laser was developed in 1960 with widespread use in human surgery by the late 1980’s. The most commonly used veterinary surgical laser is the CO2 laser. The wavelength of the CO2 laser beam energy is absorbed into the water found in skin and other soft tissue cells. When this infrared energy is absorbed, the water inside the cells is vaporized, resulting in “cutting” of the tissues. The surgeon can accurately control the extent to which the laser beam is absorbed into the surrounding tissue, allowing extreme surgical precision. The laser is often superior to stainless steel surgical blades for many procedures, especially tissue with numerous small blood vessels or in areas adjacent to delicate organs or structures.

There are three reported major advantages of laser surgery over traditional stainless steel for many veterinary patients: 1) Deceased pain, 2) Reduced bleeding and blood loss and 3) Quicker recovery time.

  • Decreased post-operative pain is accomplished when the laser seals the nerve endings as it cuts. The laser also seals lymphatic vessels, creating less edema or swelling. This helps reduce pain impulses from the surgery site.
  • Reduced bleeding and blood loss is achieved through cauterization of blood vessels as the laser beam vaporizes the tissues. Less bleeding can improve the veterinarian’s ability to clearly see the surgical field by sealing the capillaries and small blood vessels.
  • Quicker recovery time is often observed in patients undergoing laser surgery. There is a reduced risk of infection due to the superheating and sterilization of tissues in the incision site that destroys most bacteria. Less swelling and pain also contribute to quicker recovery times after laser surgery in pets.  

Almost any soft-tissue surgery can be performed with CO2 laser. Routine procedures such as spays and neuters are now commonly done with surgical lasers at many veterinary practices. The CO2 laser is also used for skin tumor removal, many cancer surgeries, eyelid, ear, nose, and mouth surgeries. I especially prefer CO2 laser for surgery in reptiles and birds because I can eliminate most surgically-induced blood loss and have an unobstructed view of the tiny tissues I’m cutting. Ask your veterinarian if CO2 laser would help your pet if it requires surgery.  

Traditional surgery using stainless steel blades will always have a place in veterinary surgery. Traditional methods are well-established and proven, low-cost, and versatile. Skilled veterinary surgeons can have the same, or better, results using scalpel blades instead of CO2 laser. I’ve always approached veterinary laser surgery as adjunctive to traditional techniques. There are certain procedures such as oral tumors that I exclusively rely on CO2 laser. Other procedures, including spays and neuters, I offer as an alternative for pet parents interested in newer techniques. CO2 laser units are quite expensive to purchase and maintain, and not all veterinarians will choose to invest in this technology. There continues to be debate within both the human and veterinary surgical communities on which technique is better. My answer is the best procedure is whatever the surgeon is more comfortable with. I’ve used surgical lasers for 15 years and understand the limits and power of the technology. Talk with your veterinarian about the pros and cons of laser surgery for your pet.