The applications of laser in both adults and pediatric neurosurgery are being steadily refined today. For many routine tumor removals, contemporary lasers do not add to ultrasonic aspiration or suction resection. However, there are some tumors in which one CO2 laser is invaluable; brain stem astro cytomas, skull base tumors, and intraspinal tumors are examples. Similarly, in resections of spinal lipomas they are useful to vaporize lipomas from the roots. Laser welding of vessels is technically possible but has generally not been useful. Perhaps the most exciting application is a combination of laser energy transfer with stereotactic technology. The MRI can be used to visualize structural changes in cerebral tissue. We have used this technology in 40 rats with gliomas and have been able to demonstrate destruction.
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