Lasers Ndyag Co2

An Introduction to Medical Lasers
– Solid State (Nd:YAG) and Gas (CO2)
Ashish Sundar
Medical Equipment Planner
Lasers – History
Acronym for Light Amplification by Stimulated Emission of Radiation[1].

Definition: A device that emits light through a process of optical amplification based
on the stimulated emission of electromagnetic radiation[2],[3].
Built in 1960 Based on

by Theodore theoretical
H. Maiman work
at Hughes by Charles
Research Hard
Laboratories Townes and
Arthur
Leonard
Schawlow
One of the most influential achievements of the

20th century.
[1] "BBC - 7 words you probably didn't know were acronyms". BBC. Retrieved May 18, 2021.
[2] ^ "Why Laser Doesn't Have a 'Z'". Merriam Webster. Retrieved May 18, 2021. 'Laser' is an acronym
[3] Gould, R. Gordon (1959). "The LASER, Light Amplification by Stimulated Emission of Radiation". In Franken, P.A.; Sands R.H. (eds.). The Ann Arbor Conference on Optical Pumping, the
University of Michigan, 15 June through 18 June 1959. p. 128. OCLC 02460155.
Lasers – Components
• An energy source (usually referred to as the pump or pump source),
• A gain medium or laser medium, and
• Two or more mirrors that form an optical resonator.
[5]
[4]
Worlds first laser system – Ruby Laser, was presented to the world
by Maiman and his employer, Hughes Aircraft Company on July 7,
1960 [6]
[4] https://www.autodesk.com/products/eagle/blog/how-lasers-work/
[5] https://www.researchgate.net/figure/a-Theodore-Maimans-first-laser-removed-from-aluminum-cylinder-used-during_fig2_46158628
[6] Townes, Charles H. (2003). Laura Garwin and Tim Lincoln (ed.). "The First Laser". A Century of Nature: Twenty-One Discoveries that Changed Science and the World. University of Chicago
Press. pp. 107–12.
The gain medium is excited by the pump source to produce a population

inversion, and it is in the gain medium where spontaneous and stimulated
emission of photons takes place, leading to the phenomenon of optical gain, or
amplification. The gain medium is the major determining factor of the
wavelength of operation, and other properties, of the laser. Gain media in
different materials have linear spectra or wide spectra. Gain media with wide
spectra allow tuning of the laser frequency.
[8]
[7]
Gain medium
[7] https://liqui-laser.com/inicio/en/category/business-news/?v=48a60f7b44e7
[8] https://en.wikipedia.org/wiki/Laser_construction
The pump source is the part that provides energy to the laser system. Examples
are electrical discharges, flash lamps, arc lamps, light from another laser,
chemical reactions.
Gas lasers such as carbon dioxide, argon, krypton and mixtures such as helium–neon are often pumped by
electrical discharge. Solid state lasers, such as neodymium doped yttrium aluminium garnet are usually pumped
by flashlamps or light from another laser. Semiconductor lasers are pumped with a simple electric current. Dye
laser operation is determined with the exact chemical configuration of the added dye molecules
(coumarin, rhodamine, and fluorescein) in organic chemical solvents such as (methanol, ethanol or ethylene
glycol). Excimer lasers use a chemical reaction.
[7] [8]
Pump source
The optical resonator, or optical cavity, in its simplest form is two parallel
mirrors placed around the gain medium, which provide feedback of the light. The
mirrors are given optical coatings which determine their reflective properties.
Typically, one will be a high reflector, and the other will be a partial reflector. The
latter is called the output coupler, because it allows some of the light to leave
the cavity to produce the laser's output beam.
Optical resonator
[7] [8]
Lasers – The Physics
Stimulated Spontaneous Stimulated

Absorption Emission Emission
Ground State
Energy = 1
Excited State
Energy = 5

An atom with two

energy levels (Ground
state and Excited
state)
Energy = 4
Photon with an energy
equal to the difference in
energy levels of the two
states
Ground State – E1
Excited State – E2 Ground State
h is Plank’s constant Energy = 1
ν is the frequency of the
photon
ΔE = E2 – E1 Excited State
hν = ΔE Energy = 5

Incident photon
annihilates and the
electron is excited to
the higher stage.
Ground State
Energy = 1
Excited State
Energy = 5

Ground State
Energy = 1
Excited State
Energy = 5

An atom with an
electron that is
already in the Excited
state.
Ground State
Energy = 1
Excited State
Energy = 5

Disturbances in the
environment
Perturbations cause
the excited electron to
fall down to ground
state.
Ground State
Energy = 1
Excited State
Energy = 5

This transition caused

a photon to be
released.
Energy = 4
Ground State
Energy = 1
Excited State
Energy = 5

An atom with an
electron that is
already in the Excited
state.
Ground State
Energy = 1
Excited State
Energy = 5

An atom with an
electron that is
Energy = 4 already in the Excited
state.
Photon with an energy

equal to the difference in
energy levels of the two
states
Ground State
Energy = 1
Excited State
Energy = 5

The incident photon

causes disturbances in
the environment of
the excited electron
but without being
annihilated.
Ground State
Energy = 1
Excited State
Energy = 5

Both the radiation

waves exit the atom.
These radiation waves
are now in same
frequency, phase,
polarization and
energy; coherent
waves.
Ground State Basis of Laser is to

Energy = 1 avalanche this effect.
Excited State
Energy = 5
It is possible for multiple atoms to undergo spontaneous emission releasing photons in

different directions. In this case the released photons are not coherent
Ground State Ground State

Energy = 1 Energy = 1
Excited State Excited State

The excited state can hold electrons for a short duration of time only, 100 ns.


Enough time has to be provided for the excited electrons to interfere with incident
photon for stimulated emission to happen and hence metastable states are introduced.

Metastable State
Energy = 4.9
Metastable states have a much longer lifetime than excited states, milliseconds.

Metastable State
Energy = 4.9
Photons with energy equal to E2 – E1 would excite the electrons to excited level.

Metastable State
Energy = 4.9
Since excited level can hold these electrons for a small period of time, they fall down to
metastable state rapidly.

Metastable State
Energy = 4.9
The transition from excited state to metastable state does not produce radiation. The
energy difference is released as heat to the gain medium.

Metastable State
Energy = 4.9
A passing photon triggers the fall of electrons to ground level without being annihilated
causing spontaneous emission. The energy of these photons will be equal to 3.9

Metastable State
Energy = 4.9
Pumping photon energy > Photons that are being lased

Metastable State
Energy = 4.9
Concept of population inversion





Amplification – Use of Mirrors
[8]
• Light from the medium, produced by spontaneous emission, is reflected by the

mirrors back into the medium, where it may be amplified by stimulated emission.
• The light may reflect from the mirrors and thus pass through the gain medium
many hundreds of times before exiting the cavity.
• Configurations with four or more mirrors forming the cavity are used in more
complex lasers. The design and alignment of the mirrors with respect to the
medium is crucial for determining the exact operating wavelength and other
attributes of the laser system.
Unique Properties:
High temporal coherence
Uses:
Communication
Spectroscopy
Interferometry
Sensors
Holography
http://ocw.mit.edu/RES-6-005S08
Lasers – Unique Properties
High monochromaticity (one color) Highly collimated beam

Diffraction limited collimation
Narrow spectral width
Uses:
Bar code readers
Communication
Radar
Medical (Surgery) deep anatomical regions
Unique Properties:
High power Very small focal spot

Diffraction limited focusing
Very short pulse width
Spectrum:
[9]
[9] Jaipur National University, School Pharmaceutical Sciences/Laser/Vineet Gupta

Carbon Dioxide (CO2)Laser
• The CO2 laser was one of

the earliest gas lasers .
• Invented by Kumar Patel of
Bell Labs in 1964.[10]
• The ratio of output power
to pump power can be as
large as 20% making it a
highly efficient laser.
• The CO2 laser produces a
beam of infrared region of • A way to remove the waste heat
the electromagnetic generated.
spectrum. • Molecular system can produce
• The principle wavelength higher energy with comparably
lies at 9.6 micrometers and lower waste heat production.[11]
10.6 micrometers.
[10] Patel, C. K. N. (1964). "Continuous-Wave Laser Action on Vibrational-Rotational Transitions of CO2". Physical Review. 136(5A): A1187
A1193. Bibcode:1964PhRv..136.1187P. doi:10.1103/physrev.136.a1187
[11] http://www.pranalytica.com/
[7]
• It consist of discharge tube of size 2.5cm in diameter and 5.0cm in length. Two
optically plane and parallel mirrors, one is a complete reflector and another is
partial reflector.[12]
• The discharge is filled with a mixture of CO2, N2 and He gases at a pressure of
a few mm of mercury.
• A high DC voltage is used for electric discharge in the tube due to which CO2
molecules breaks into CO & O.
[12] Yong Zhang and Tim Killeen, Gas Lasers: CO2 Lasers - progressing from a varied past to an application-specific future, LaserFocusWorld (4 November 2016)
Carbon Dioxide (CO2) Laser
Active Medium
Ratio
CO2:N2:He
1:4:5
Helium acts as
a cooling agent
inside the
active medium.
Heat from the

tube is further
reduced by the
use of water or
gas.
https://www.globalspec.com/learnmore/optical_components_optics/lasers/carbon_dioxide_lasers
Carbon Dioxide (CO2)Laser - Physics
Vibrational and Rotational stages of CO2 [14]
Triatomic linear CO2 molecule has three atoms. Therefore, the molecule has
3n degrees of freedom. For linear molecules, there will be (3n-5) fundamental
vibrations. Therefore, CO2 molecule will have 4 fundamental vibrations.[13]
[13] http://cepekmedia.co.nf
[14] https://www.geoexpro.com/articles/2020/08/recent-advances-in-climate-change-research-part-viii-how-carbon-dioxide-absorbs-earth-s-ir-radiation
[15]
As a result of
electric discharge,
electrons collide
with the N2
molecules and
excite them to their
vibrational levels.
These vibrational
Spontaneous emission levels are close to
the energy of the
Interaction with He atoms
asymmetric
vibrational states
of CO2 molecules.
The excited N2 molecule populates the asymmetric vibrational states in the CO2
molecules through collisions.
[15] https://www.intechopen.com/books/laser-pulses-theory-technology-and-applications/longitudinally-excited-co2-laser
Concept of Transverse Excitation in TEA CO2 laser
• Higher gas pressure is used to obtain higher energy output per unit volume
of gas
• Lasers operating at a higher gas pressure (1 ATM) often encounter arching
issues while operating in longitudinal discharge scheme with a higher
voltage and when the gas is not completely ionized.[16]
• In transversely excited lasers, two electrodes are arranged parallel to each
other over the length of the discharge separated by few centimetres and
employees a pre-ionization mechanism through UV sparks which ensures
uniform discharge throughout its length preventing arching.
• One of the major advantages of this configuration is many Joules of energy
can be produced for each litre of discharge volume
[16] Pearson, P.; Lamberton, H. (1972). "Atmospheric pressure CO2lasers giving high output energy per unit volume". IEEE Journal of Quantum Electronics. Institute of Electrical and Electronics
Engineers (IEEE). 8 (2): 145–149. doi:10.1109/jqe.1972.1076905. ISSN 0018-9197.
http://www.wavetopsign.com/productinfo/143373.html
Interaction with Soft Tissue
[17]
[17] https://www.aesculight.com/case-studies/why-co2-laser-performs-soft-tissue-surgery-well/
Application in Medicine
• Application in neurosurgery: Mainly used in the removal of tumors
by evaporation where surgical approach of the tumor site is difficult
• Disk herniation: CO2 laser-assisted microdiscectomy could be an
effective alternative to conventional microdiscectomy techniques
• ENT surgery: Laryngeal microsurgery using CO2 laser.
• Urology: Genital wart removal.
• Dermatology: Non ablative fractional skin resurfacing.
CO2 Vaporization Laryngeal Pappilomatosis
The CO2 laser can be used in a continuous, pulsed, or superpulsed mode. The
superpulsed mode reduces the exposure time to a few nanoseconds while delivering
high energies of 400 to 500 W with each peak. The rest time between each peak allows
the tissues to cool and reduces thermal injury to adjacent tissues.
https://www.sciencedirect.com/topics/immunology-and-microbiology/carbon-dioxide-laser
Mode of Operation
• Continuous-Wave Mode
– The laser works with a continuous-wave beam which emits energy continuously at a
constant output power as long as the footswitch is held down.
• Single-Pulse Mode
– Allows the application of single pulses whose intensity and duration can be defined by
the user. Upon operating the footswitch and holding it down, the laser emission
process will be interrupted as soon as the selected pulse time has elapsed
• Pulse-Train Mode
– The laser emits a sequence of laser pulses until the footswitch is released again.
www.klsmartin.com
Fractional CO2 skin resurfacing
• Laser passes into the deeper layer

of skin called Dermis.
• Laser stimulates and rejuvenate
cells to produce collagen.
• End result is a skin with more
elasticity and quality.
https://lincolnlaserskincare.com/treatments/fractional-laser-resurfacing
Fractional lasers create

microscopic heat columns
causing areas of thermal
damage known as (MTZs) or
microscopic thermal zones
ranging from 100 to 400 μm
in width and approximately
300 to 700 μm in depth.
The MTZs are separated by

areas of normal skin, which
acts as a reservoir for tissue
regeneration.
MTZ comprises up to 15 to
25 percent of the skin
surface area per treatment
session.
https://lincolnlaserskincare.com/treatments/fractional-laser-resurfacing
Ablative laser skin resurfacing is one of the
most effective cosmetic procedures for
improving aging skin. The procedure works
by delivering an intense wavelength of light
to the skin, which removes the outer layers
of aged or sun damaged skin. In addition,
the laser stimulates the underlying skin,
resulting in collagen formation and an
improvement in wrinkles.
Ablative fractional lasers have longer wavelengths in the range of 2940 to 10600nm and
lead to full thickness destruction of skin. These are usually associated with greater efficacy
but longer recovery time and higher risk of complications in Skin Types IV to VI.
Non-ablative fractional lasers have wavelengths ranging from 1320 to 1927nm and leave a
functionally and histologically intact stratum corneum.
Non-ablative lasers, on the other hand, don’t

remove any skin layers. These include pulsed
light, pulsed-dye lasers, and fractional lasers.
Non-ablative lasers may be used for rosacea,
spider veins, and acne-related skin concerns.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605208/
www.klsmartin.com
Nd:YAG Lasers
Neodyminum-doped Yttrium Aluminum Garnet Lasers
• Laser operation of Nd:YAG was first demonstrated by J.E. Geusic,

H.M. Marcos and L.G. Van Uitert at Bell Laboratories in 1964. [18]
The dopant, triply ionized neodymium, Nd(III), typically replaces a small fraction
(1%) of the yttrium ions in the host crystal structure of the yttrium aluminum
garnet (YAG), since the two ions are of similar size.[19] It is the neodymium ion
which provides the lasing activity in the crystal.
• For continuous wave output, the doping is significantly lower

than for pulsed lasers.
• These are one of the most common types of laser, and are used
for many different applications.
[18] Geusic, J. E.; Marcos, H. M.; Van Uitert, L. G. (1964). "Laser oscillations in nd-doped yttrium aluminum, yttrium gallium and gadolinium garnets". Applied Physics Letters. 4 (10):
182. Bibcode:1964ApPhL...4..182G. doi:10.1063/1.1753928
[19] Walter Koechner (1965) Solid-state laser engineering, Springer-Verlag, p. 507
Nd:YAG Lasers
• Solid state laser

• Four level laser system
• Nd – Neodymium ions
(active Centers)
• YAG – Host material
https://www.youtube.com/c/EngineeringPhysicsbySanjiv/about
Nd:YAG Lasers
• Four level laser system.

Energy level E4 – E6 are
considered as one level
• One metastable state
at E3
• Laser beam emitted at
1.06µm (Infrared)
• Efficiency better than
1%
• However, there are also
transitions near 946,
1120, 1320, and
The high-intensity pulses may be efficiently frequency 1440 nm.
doubled to generate laser light at 532 nm, or higher
harmonics at 355, 266 and 213 nm.[20]
https://www.youtube.com/c/EngineeringPhysicsbySanjiv/about
[20] Yariv, Amnon (1989). Quantum Electronics (3rd ed.). Wiley. pp. 208–11. ISBN 978-0-471-60997-1.
Nd:YAG Lasers: Application in Medicine
[21]
Blocked trabecular mesh Laser is used to create a

work can increase the IOP minor incision in the iris
In ophthalmology
• To correct posterior capsular opacification, after cataract surgery, for
peripheral iridotomy in patients with chronic and acute angle-closure
glaucoma, for the treatment of vitreous eye floaters.[22]
• For pan-retinal photocoagulation in the treatment of proliferative diabetic
retinopathy.
[21] https://www.sharp.com/services/eye/
[22] Dias-Santos, Arnaldo; Ferreira, Joana; Abegão Pinto, Luís; Domingues, Isabel; Silva, José Pedro; Cunha, João Paulo; Reina, Maria (April 2015). "Phacoemulsification versus peripheral
iridotomy in the management of chronic primary angle closure: long-term follow-up". International Ophthalmology. 35 (2): 173–178. doi:10.1007/s10792-014-9926-
8. hdl:10400.17/2093. ISSN 1573-2630. PMID 24728533. S2CID 14929770
[24]
[23]
Extensively used in the field of

cosmetic medicine for laser hair
removal and the treatment of
minor vascular defects such
as spider veins on the face and
legs.
[23] http://www.lecrisadore.com/nd-yag-laser.html
24] www.sciton.com
1319 nm laser delivered through a fiber,

in three different modes.
The three modes used are Burst, Melt,
and Tighten.
Burst mode is used to sever septae that
cause dimpling, Melt mode is used melt
fat underlying bulging tissue, and
Tighten mode is used to the tighten the
dermis by stimulating collagenesis.
www.sciton.com
• Widely used laser for laser-induced thermotherapy, in which benign or malignant
lesions in various organs are ablated by the beam.
• Nd:YAG lasers can be used to remove skin cancers and to reduce benign thyroid
nodules
• To treat benign prostatic hyperplasia (BPH), Nd:YAG lasers can be used for laser
prostate surgery—a form of transurethral resection of the prostate
[26]
[25]
[25] https://www.pushya.org/prostate-laser-surgery-ahmedabad.php
[26] www.olympusmedical.com

Lasers Ndyag Co2

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Lasers Ndyag Co2

Uploaded by

Copyright:

Available Formats

An Introduction to Medical Lasers

– Solid State (Nd:YAG) and Gas (CO2)

Acronym for Light Amplification by Stimulated Emission of Radiation[1].

Built in 1960 Based on

One of the most influential achievements of the

The gain medium is excited by the pump source to produce a population

Stimulated Spontaneous Stimulated

Stimulated Spontaneous Stimulated

An atom with two

Stimulated Spontaneous Stimulated

Stimulated Spontaneous Stimulated

Stimulated Spontaneous Stimulated

Stimulated Spontaneous Stimulated

Stimulated Spontaneous Stimulated

This transition caused

Stimulated Spontaneous Stimulated

Stimulated Spontaneous Stimulated

Photon with an energy

Stimulated Spontaneous Stimulated

The incident photon

Stimulated Spontaneous Stimulated

Both the radiation

Ground State Basis of Laser is to

It is possible for multiple atoms to undergo spontaneous emission releasing photons in

Ground State Ground State

Excited State Excited State

Ground State Ground State

Excited State Excited State

Ground State Ground State

Ground State Ground State

Ground State Ground State

Ground State Ground State

Ground State Ground State

Ground State Ground State

Pumping photon energy > Photons that are being lased

Ground State Ground State

Concept of population inversion

Concept of population inversion

Concept of population inversion

Concept of population inversion

Concept of population inversion

• Light from the medium, produced by spontaneous emission, is reflected by the

High temporal coherence

High monochromaticity (one color) Highly collimated beam

Narrow spectral width

High power Very small focal spot

Very short pulse width

[9] Jaipur National University, School Pharmaceutical Sciences/Laser/Vineet Gupta

• The CO2 laser was one of

Heat from the

Vibrational and Rotational stages of CO2 [14]

Concept of Transverse Excitation in TEA CO2 laser

• Laser passes into the deeper layer

Fractional lasers create

The MTZs are separated by

Non-ablative lasers, on the other hand, don’t

Neodyminum-doped Yttrium Aluminum Garnet Lasers

• Laser operation of Nd:YAG was first demonstrated by J.E. Geusic,

• For continuous wave output, the doping is significantly lower

• Solid state laser

• Four level laser system.

Blocked trabecular mesh Laser is used to create a

Extensively used in the field of

1319 nm laser delivered through a fiber,