Bob:

Thanks for you help here and also with the discussion on hemostasis and pulse duration. I continue to read Manni’s book – these “technical bulletins” you are posting are quite helpful.

Al

I look at the pictures and know this is great fun learning all these new methods. This is such a tremendous forum to share on.

I have found that the difference in wavelength (and therefore the tissue interaction) of the laser made a significant difference in the removal of a fibroma as you have presented. With regards to the depth of the cut you make – the fibroma should be the determining factor. With the erbium or the Diode you must decide where you will make your cut. Many times the tissue will feel the same and it is hard to differentiate what you’re removing from tissue you wish to keep. I also see this dilemma in the questions that are posed. With the FR Nd:YAG used in a selective ablation mode these tissues are recognizable and are able to be distinguished one from the other and separated. Thus you are able to remove the complete fibroma without sacrificing any additional tissue unnecessarily. Now that Bob has the camera and scope set up we will post the next one of these we remove – I hope he lets me use the camera!

NOPE!! uh, ah. ain’t sharin’….:biggrin:

Here is my first fibroma removal using the OpusDuoE.
10 Hz 350mJ using a 800micron tapered sapphire contact tip for less than 30 sec.
LA 2% Carbocaine w/ 1/20,000 Levordefren, tripod technique (3 drops in triangle surrounding lesion in mucosa)

Before

Immediately after

Next time I’ll use a 200 or 400micron tapered tip for more focused tissue response.

Jeff