Laser surgery

Laser surgery is a medical procedure that uses laser light to remove diseased tissues or treat bleeding
blood vessels. Laser surgery may also be used for cosmetic purposes, such as removing wrinkles,
tattoos, or birthmarks.

Description
A laser is a light beam that can be precisely focused. It is used to treat tissues by heating the targeted
cells until they "burst."
There are several types of lasers, including the carbon dioxide (CO2) laser, the YAG (yttrium aluminum
garnet) laser, and the pulsed dye laser. Each laser has specific uses. The color of the light beam used is
directly related to the type of surgery being performed and the color of the tissue being treated.

Why the Procedure is Performed

Laser surgery can be used to:

 Close small blood vessels to reduce blood loss

 Close lymph vessels to reduce swelling and decrease the spread of tumor cells
 Close nerve endings to reduce pain that occurs after surgery
 Remove tumors (such as those in the brain or liver)
 Remove warts, moles, and tattoos
 Reduce the appearance of skin wrinkles, scars, and other skin blemishes
 Remove hair

Risks
Possible risks of laser surgery include:

 Bleeding
 Incomplete treatment of the problem
 Infection
 Pain
 Scarring
 Skin color changes

Some laser surgery is done when you under general anesthesia. Be sure to discuss the risks with your
health care provider.

After the Procedure

How well a patient does depends on the condition being treated. Always talk to your health care provider
about your expected recovery before surgery.

Outlook (Prognosis)
The amount of time it takes to recover from surgery depends on the surgery and on the individual. Based
on an evaluation of your health status prior to surgery, your health care provider can give you a good
estimate of the recovery time.
Laser therapy

A laser is used for many medical purposes. Because the laser beam is so small and precise, it enables
physicians to safely treat specific tissue without injuring surrounding tissue. Some uses of the laser are
retinal surgery, excision of lesions, and cauterization of vascular structures.

Lasik eye surgery - series

The cornea is the transparent part of the eye that covers the iris. It is also the main light bending part of
the eye.

Procedure, part 1

Anesthetic eye drops are given to numb the eye and the surgeon marks the cornea with water-soluble ink
to guide replacement of the corneal flap.

Procedure, part 2

The surgeon performs a keratectomy which creates a corneal flap. A keratectomy is a procedure that
uses a small instrument that makes a cut in the cornea as it moves across it. The flap is lifted and
reflected exposing the cornea beneath.
Procedure, part 3

A computer-controlled laser reshapes the cornea to the prescribed shape for clear vision.

Aftercare

The corneal flap is repositioned and bonds to the cut edge of the cornea quickly.
Endoscopy
 
Endoscopy is a procedure that lets your doctor look inside your body. It uses an instrument called an
endoscope, or scope for short. Scopes have a tiny camera attached to a long, thin tube. The doctor
moves it through a body passageway or opening to see inside an organ.

How do endoscopes work?

Here's how endoscopy works:

1. Light from a bright lamp outside the patient's body shines into one of the endoscope tubes.
2. The light bounces along the walls of the fiber-optic endocope tube into the patient's body cavity.
3. The diseased or injured part of the patient's body is illuminated by the light shining in.
4. Light reflected off the body part travels back up a second fiber-optic tube, bouncing off the glass
walls as it goes.
5. The light shines up into the physician's eyepiece so, looking down, the physician can see what's
happening inside the patient's body
Rigid endoscope. (a) Internal optical arrangement. Illumination is provided by optical fibres which lie
parallel to the axis of the probe, between the relay-lens tube and the outer protective sheath. The
mirror tube fits around the latter and can be rotated by hand or mechanically. The angle of view can be
adjusted by changing the angle of the mirror.

Sometimes scopes are used for surgery, such as for removing polyps from the colon.

There are many different kinds of endoscopy. Here are the names of some of them and where they look.

 Arthroscopy: joints
 Bronchoscopy: lungs
 Colonoscopy and sigmoidoscopy: large intestine
 Cystoscopy and ureteroscopy: urinary system
 Laparoscopy: abdomen or pelvis
 Upper gastrointestinal endoscopy: esophagus and stomach
Bronchoscopy

Bronchoscopy is a surgical technique for viewing the interior of the airways. Using sophisticated flexible
fiber optic instruments, surgeons are able to explore the trachea, main stem bronchi, and some of the
small bronchi. In children, this procedure may be used to remove foreign objects that have been inhaled.
In adults, the procedure is most often used to take samples of (biopsy) suspicious lesions and for
culturing specific areas in the lung.

Diagnostic laparoscopy
Diagnostic laparoscopy is a procedure that allows a health care provider to look directly at the contents of
a patient's abdomen or pelvis, including the fallopian tubes, ovaries, uterus, small bowel, large bowel,
appendix, liver, and gallbladder.

How the Test is Performed

The procedure is usually done in the hospital or outpatient surgical center under general anesthesia
(while the patient is unconscious and pain-free). However, very rarely, this procedure may also be done
using local anesthesia, which numbs only the area affected by the surgery and allows you to stay awake.
A surgeon makes a small cut below the belly button (navel) and inserts a needle into the area. Carbon
dioxide gas is passed into the area to help move the abdominal wall and any organs out of the way,
creating a larger space to work in. This helps the surgeon see the area better.
A tube is placed through the cut in your abdominal area. A tiny video camera (laparoscope) goes through
this tube and is used to see the inside of your pelvis and abdomen. Additional small cuts may be made if
other instruments are needed to get a better view of certain organs.
In the case of gynecologic laparoscopy, dye may be injected into your cervix area so the surgeon can
better see your fallopian tubes.
After the exam, the laparoscope and instruments are removed, and the cuts are closed. You will have
bandages over those areas.
Pelvic laparoscopy

Laparoscopy is performed when less-invasive surgery is desired. It is also called "band-aid" surgery
because only small incisions need to be made to accomodate the small surgical instruments that are used
to view the abdominal contents and perform the surgery

Incision for abdominal laparoscopy

Abdominal laparoscopy is a useful aid in diagnosing disease or trauma in the abdominal cavity with less
scarring than with a large abdominal incision. Large operations such as liver and pancreatic resections
may begin with laparoscopy to exclude the presence of additional tumors (metastatic disease) that would
preclude curative resection. The procedure is usually done in the hospital under general anesthesia,
(however it may be done under local anesthesia).

Capsule Endoscopy
A Journey Through the Gut
The term endoscopy refers to a special technique for looking inside the digestive tract. Capsule
endoscopy uses a video capsule that contains a miniature color video camera with a light,
transmitter and batteries to perform a painless examination of your esophagus and small
intestine.

You may be surprised at the size of the capsule — it is the size of a large vitamin pill, just over
an inch long and less than ½ inch wide. Once swallowed, it travels through the gastrointestinal
(GI) tract, sending multiple images a second to a recording device worn around your waist. The
capsule will not be absorbed or digested, but will move through your digestive system and be
eliminated through a normal bowel movement.

Each capsule is designed for a single use, and will not harm the environment or your household
plumbing.

Capsule Endoscopy Uses

Capsule endoscopy provides your doctor with images of your digestive system that cannot be
captured with conventional
X-rays.

Your gastroenterologist will use the images transmitted by the capsule to diagnose and evaluate a
variety of conditions, including:

 Gastroesophageal reflux disease (GERD)

 Diarrhea
 Polyps
  Anemia and bleeding
 Bowel function
 Malabsorption
 Abdominal pain
 Tumors and some cancers
 Celiac sprue
 Crohn’s disease

Your gastroenterologist may also use capsule endoscopy to monitor the progress of treatment
plans for these conditions. If your doctor detects a serious problem in your esophagus, you may
need to undergo a conventional endoscopy to confirm diagnosis and, possibly, to receive
treatment.

Preparing for the Test

There are important steps you must take to safely prepare for and participate in the procedure,
including:

 Provide your doctor a complete list of all the medicines you are taking and any allergies you
have to drugs or other substances.
 Tell your gastroenterologist if you have a pacemaker or other implanted electromedical devices.
 Discuss conditions such as previous abdominal surgery, swallowing problems or previous history
of obstructions in the bowel that may impact the test.
 For esophageal capsule endoscopy, you must fast for two hours.
 For small bowel capsule endoscopy, you should not eat or drink within 10 hours of your
procedure. Male patients may also need to shave the area around the navel.
 Do not take any medication in the two hours before your test time.
 Do not smoke for 24 hours before the test.

On the day of your test, come to your doctor’s office dressed in loose fitting, two piece clothing.
Your gastroenterologist, or a member of the medical staff, will review the procedure with you
and make sure that you understand what will be done.

Esophageal Capsule Endoscopy

Before beginning the test, a member of the medical team will place sensors on your chest using
adhesive patches. These sticky patches are connected by wires to a recording device, which you
will wear around your waist during the entire procedure.

When you are ready to begin, you will swallow the video capsule with water while lying flat on
your back. Every two minutes for six minutes you will be raised by 30 degrees until you are
sitting upright; you will remain upright for an additional 15 minutes to make sure the capsule has
traveled the length of the esophagus. Sitting up gradually slows the movement of the capsule,
allowing time for extra pictures to be taken.
During the test, the small light on the data recorder will blink to confirm that it is receiving data.

After 20 minutes, the test is complete and the sensors will be removed. You are then free to leave
the office while your doctor begins downloading and analyzing the information from the data
recorder.
Small Bowel Capsule Endoscopy
For a small bowel capsule endoscopy, the sensors will be placed on your abdomen using sticky
patches and connected by wires to a recording device, which you will wear around your waist
during the entire procedure.

You will swallow the capsule with water — sitting or standing — at your gastroenterologist’s
office or the hospital, and then you will be allowed to leave and go about your regular routine.
You will be given a form to record the time and nature of sensations and activities, including
eating and drinking.

Four hours after you swallow the capsule, you may eat a light snack, unless your
gastroenterologist tells you otherwise. You should avoid strenuous physical activity, especially if
it involves sweating, and should not bend or stoop during the test.

During the test, the small light on the data recorder will blink to confirm that it is receiving data.
If it stops blinking, contact your physician.

After eight hours, you’ll return to your doctor’s office, where the sensors will be removed and
you will turn in the data recorder and your activity log. 
After Capsule Endoscopy
After the procedure, you will need to return the data recorder and sensors to your doctor’s office.
Your gastroenterologist will download the data from the recorder and will view a color video of
the pictures.

In a few days, you will hear from your doctor with the results of your capsule endoscopy. You
may have questions you want to ask the doctor about your results or the potential next steps in
your treatment plan.

The capsule will continue passing through your digestive tract and will be eliminated through a
normal bowel movement in the next two to three days. While it is important to know that the
capsule has in fact exited your system, there is no need to attempt to retrieve the device.

Possible Complications
There have been few side effects reported with capsule endoscopy. You should contact your
gastroenterologist immediately if you:

 Develop a fever after swallowing the capsule.

 Have trouble swallowing.
  Begin to vomit.
 Experience increasing chest or abdominal pain.

Cramping and abdominal discomfort have not yet been reported during the capsule endoscopy
procedure.

Very rarely, the capsule can become stuck in the digestive tract due to a blockage or narrowing
of the intestines. In this case, surgery may be required to remove the capsule.

You are at a higher risk of blockage if you have a history of bowel obstruction or previous
gastrointestinal surgery — be sure to discuss the risks with your doctor before the procedure. If
you cannot positively confirm that the capsule has been excreted from your body within a week,
contact your gastroenterologist for an evaluation and possible abdominal X-ray to establish the
location of the capsule.

You should not undergo a Magnetic Resonance Imaging (MRI) examination or be near any
powerful magnetic fields (such as amateur or ham radio) until after the capsule is excreted.
Doing so could result in serious damage to your intestinal tract and abdominal cavity.

Biosensor
A biosensor is an analytical device which converts a biological response into an electrical signal.
The term 'biosensor' is often used to cover sensor devices used in order to determine the
concentration of substances and other parameters of biological interest even where they do not
utilise a biological system directly.
Schematic diagram showing the main components of a biosensor. The biocatalyst (a) converts
the substrate to product. This reaction is determined by the transducer (b) which converts it to an
electrical signal. The output from the transducer is amplified (c), processed (d) and displayed (e).

The key part of a biosensor is the transducer (shown as the 'black box' in Figure 6.1) which
makes use of a physical change accompanying the reaction. This may be

1. the heat output (or absorbed) by the reaction (calorimetric biosensors),

2. changes in the distribution of charges causing an electrical potential to be produced
(potentiometric biosensors),
3. movement of electrons produced in a redox reaction (amperometric biosensors),
4. light output during the reaction or a light absorbance difference between the reactants and
products (optical biosensors), or
5. effects due to the mass of the reactants or products (piezo-electric biosensors).

There are three so-called 'generations' of biosensors; First generation biosensors where the
normal product of the reaction diffuses to the transducer and causes the electrical response,
second generation biosensors which involve specific 'mediators' between the reaction and the
transducer in order to generate improved response, and third generation biosensors where the
reaction itself causes the response and no product or mediator diffusion is directly involved.

There are many potential applications of biosensors of various types. The main requirements for
a biosensor approach to be valuable in terms of research and commercial applications are the
identification of a target molecule, availability of a suitable biological recognition element, and
the potential for disposable portable detection systems to be preferred to sensitive laboratory-
based techniques in some situations. Some examples are given below:

 Glucose monitoring in diabetes patients ←historical market driver

 Other medical health related targets
 Environmental applications e.g. the detection of pesticides and river water contaminants
 Remote sensing of airborne bacteria e.g. in counter-bioterrorist activities
 Detection of pathogens[6]
 Determining levels of toxic substances before and after bioremediation
 Detection and determining of organophosphate
 Routine analytical measurement of folic acid, biotin, vitamin B12 and pantothenic acid as an
alternative to microbiological assay
 Determination of drug residues in food, such as antibiotics and growth promoters, particularly
meat and honey.
 Drug discovery and evaluation of biological activity of new compounds.
 Protein engineering in biosensors http://www.springerlink.com/content/672p4l4l45xk02j2/
 Detection of toxic metabolites such as mycotoxins
"Smart Shirt"

The commercial applications for the "Smart Shirt" are:

 Medical Monitoring
o Disease Monitoring
o Infant Monitoring
o Obstetrics Monitoring
 the "Smart Shirt" can be tailored to fit anyone, like any
other shirt. For example, a baby wearing a GTWM
could have his or her vital signs monitored. This would be especially helpful since some
babies are prone to sudden infant death syndrome (SIDS), which often strikes
unexpectedly during sleep. (See above Figure )
Continuous Glucose Monitoring

Continuous Glucose Monitoring

System. A - Sensor. B - Sensor inserter known as a Senserter. C - Monitor. D -
Monitor connected to a docking station and downloading data into a computer.
One of the most obvious applications of this technology is in the treatment of diabetes.
Biosensors could monitor a patient's glucose levels. The sensors would send the collected data
to an insulin pump which would determine how much, if any, of fast-acting insulin was needed
at any particular time. The pump would have a subcutaneously-inserted drug inlet.

Sensor-augmented pump consisting of a Guardian RT sensor (A), which is

attached to a Minilink transmitter (B) and they communicate with an insulin
infusion pump (C).
This biosensor network could allow diabetics to go through the day without having to check
glucose levels every few hours. It would eliminate the need for multiple pin-prick tests. Both
the sensor and the insulin pump could take the form of simple patches. The subject could
replace the patches every few days. In a way, this biosensor network and drug pump would
work together as an artificial pancreas.

Insertion of the FreeStyle Navigator: A - Attach sensor mount to the skin. B -

Press to insert sensor. C - Attach transmitter to the sensor mount. D - Data is
transmitted to the receiver.

The CGMS measures interstitial fluid glucose continuously. It calculates and stores a reading
every five minutes over a 72-hour period. The CGMS does not provide the glucose results in real
time, but rather downloads the readings after they have been collected, the way a 24-hour
cardiac holter monitor provides information about cardiac rhythms after they have occurred .

Multi-function pulse monitor has finger sensor probe * Programmable for upper & lower limit
pulse W/ alarm * Displays include: time of day, stopwatch, alarm, upper & lower pulse limit
alarm & pulse rate recovery *

This Wearable device used to idemtify the blood pressure, pulse etc.,
 BIOTRONIK is making available its portable implanted cardiac device monitoring technology
for global sales. The system is designed to establish a communication link between ICD's, CRT's,
and pacemakers with clinics via a cell phone network.

MD keeper

The new unit measures e.g. patients' pulse, cardiac rhythm and blood oxygen values without
inconveniencing them. The user, e.g. at-risk patients with cardiac or circulatory diseases, patients with
chronic illnesses and seniors can enjoy constant monitoring and support without having to visit their
doctor. The information is stored on a chip, analyzed and transmitted in real time or as needed over
the GSM/GPRS network to a medical center. "This is the first time that a medical control device has
been combined with mobile communication technology, enabling people in need to be monitored
anywhere anytime and maintain their normal lifestyle".
In addition to biosensors and a radio module, the unit
has everything the user needs to send emergency calls
or place mobile calls to predefined people or call
centers. Thanks to its integrated MC55 Siemens radio
module, the device works almost everywhere in the
world on all GSM/GPRS networks.The unit is very
lightweight and easy to operate.
As medicine has evolved, there is a much greater awareness of the significance of peripheral nerve
function, whether it’s neuropathy in diabetic patients or nerve injuries such as carpal tunnel syndrome
(CTS). Nerve conduction studies are still the “gold standard” diagnostic tool for the assessment of
nerve problems.

Unfortunately, the traditional method of evaluating nerve function, the EMG/NCV device is arguably
one of the most painful diagnostic tests that a patient can undergo. Besides the pain elicited from the
exam, these tests are referred out which usually results in a 2-3 week delay in acquiring the
information necessary to implement care.

Neurometrix has devised the NC-stat system which has revolutionized the way in which patients
receive nerve conduction studies.

The system has three basic components:

1)  BIOSENSORS  -   Single use transducers with integrated biosensors that are anatomically
outlined for accurate placement.

2)   MONITORS   -  Displays nerve conduction response parameters in real- time on LCD screen, and
stores data for transmission.

3)   DOCKING STATION - Receives data and transmits data via fax line to a neurodiagnostic group
who interprets the data and sends a detailed report back in 30 minutes