The procedure removed growths from the airway of a patient using new technology that allows the surgery to be done in the doctor's office with the patient completely awake, and the patient to go home immediately afterward. In the past, this surgery required equipment that could be used only in the operating room with the patient under general anesthesia, and the patient was often required to spend the night in the hospital.
In the procedure this week, two different lasers were used: a carbon-dioxide (CO2) laser delivered by a newly developed hollow-core optical fiber, and a pulsed-dye laser delivered by standard solid optical fiber. Each is guided by a high-resolution video-endoscope, and the entire system is delivered to the patient through a tiny tube that is placed in the nose. It was the world's first use of both lasers in an office-based procedure.
The surgery was performed by Jamie Koufman, M.D., professor of surgery-otolaryngology at Wake Forest Baptist and director of the Center for Voice and Swallowing Disorders (www.thevoicecenter.com).
Koufman explained that the two lasers are complementary. The CO2 first removes the growths in the larynx (voice box) and trachea (airway to the lungs), and the pulsed-dye laser is then used to treat the base of the growths and help prevent recurrence.
This week Koufman removed recurrent respiratory papillomas, warts that cause severe hoarseness and obstruct the trachea; left untreated, the condition can be fatal.
She said that she chose a papilloma case for the trial of the new approach "because this is one of the worst growths to remove. If we can do the worst case, we can do almost everything else."