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Recently, 2 &mgr;m cw laser systems have been introduced for surgery. The 2 &mgr;m wavelength is predominantly absorbed by
water and enables effective cutting and ablation of tissue similar to the cw CO2 laser. In contrast to the CO2 laser, the 2
&mgr;m wavelength is delivered through fiber optics and available for endoscopic procedures.
After many years of experience with the 1.06 &mgr;m Nd:YAG laser, we started to use the 2 &mgr;m cw laser as alternative for
various urological treatments. The treatments strategies and optimal settings were examined in the lab comparing the
two 1.06 and 2 &mgr;m wavelengths performing thermal measurements. Consequently, the laser was applied for various
urological cases.
Penile tumors were resected with haemostatic effects and good aesthetic healing comparable with the Nd:YAG laser.
Although the Nd:YAG has initially a deeper penetration, the blackening of the fiber during tissue cutting, provides a
more superficial effect like the 2 &mgr;m laser.
Bladder (pre)malignancies were ablated after biopsy. Only with higher stage tumors, coagulation depth of the Nd:YAG
might be preferable for adequate treatment.
Strictures in the urethra were incised and stents were effectively desobstructed: one patient with a stent implanted after a
pelvic trauma, and one patient with catheterizable apedico stoma stenoses. The thermal damage during incision to
deeper layers is minimal so recurrence due to scarring is not expected. Also hair grow in patients who underwent
urethroplasty was effectively treated and scrotal atheromata cysts were effectively resected without recurrence.
Laparoscopic nefrectomies are being considered using the 2 &mgr;m cw laser.
The 2 &mgr;m cw laser has shown to be a versatile instrument for effective treatment of various urological indications. More
patients and long term results are needed to prove the clinical significance compared to other treatment modalities
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