[Evaluation of the use of the CO2 laser in 134 patients with expansive processes in the central nervous system].

The laser began to be used in neurosurgery towards the end of the 60s. The early experience of their clinical use did not promise much; but from the first half of the 70s with the improvement of the laser and the accumulation of laboratory and clinical experiences, the new technology began irrepressibly to spread throughout the world. Three lasers are in use today: CO2, ND.YAG and Argon laser. Each one of them, due to their different wave length and electromagnetic radiation, gave separate characteristics of employment, i.e., the interaction between the biologic tissues and the radiation is different. Depending upon the type of intraoperative needs we will choose one of the lasers. Presently the CO2-laser is the most used in neurosurgery due to its characteristics of low penetration into the tissue and the vaporization of the tissue which is exposed to the radiation. That is why such a laser (Sharplan 1060) has been acquired by our clinic. During one year we performed 134 operations due to expansive processes in the CNS with a partial or complete use of the laser during every phase of the operation. The accumulated experiences showed that the laser is a fairly useful new tool during the various surgical situations with a wide use of the everyday work of the neurosurgeon; with its implementation we have significantly improved the surgical technique in the tumors of the CNS, both in terms of radicality as well as in sparing the healthy tissue. We believe that the laser has an absolute indication in all the glioma tumors regardless of the localization, thereafter in all remaining tumors which are not extremely supplied by blood, while at the same time reducing the time needed for the surgical procedure. In time we spread the use of the laser on arteriovenous malformations as well, which, until now, has not been suggested in literature. Our results on 4 smaller superficial angiomas fully justified the use of a laser in such cases. But it also showed us that generally the laser is still a fairly unresearched surgical innovation, and that in the future wil bring about the wider implementation of this technology in the neurosurgical operating rooms. The final results of our operations and the experiences the other neurosurgical centers in the world that use the laser, regardless of which kind have justified investment of this new surgical technology.