FOR centuries, surgeons wanting to cut into bones have had to rely on the most basic of
tools - the saw and the drill - to perform their operations.
But following what is being described as a "significant breakthrough", researchers from Manchester have developed a laser which can cut through bone with millimetre precision, and without damaging the surrounding tissue.
The laser will be unveiled this week at the Institute of Physics' Annual Congress and will be viewed with interest by surgeons from around the world who have long battled with the problem of cutting and repairing bones with accuracy.
The new technology will have particular significance for brain surgery after trials showed that the laser was able to cut through the bones in the head without damaging the tissue underneath.
Dr Richard Lloyd, a maxillofacial surgeon from the Hope Hospital, Manchester, who
developed the laser with physicists from Manchester University, said neurosurgeons, ear, nose and throat, and orthopaedic surgeons had asked to take part in the patient trials due to begin this summer.
"In an area like facial deformities, the complexity of the cuts are such that the bones need to be drilled very precisely so they can slide into one another," Dr Lloyd said.
"In brain surgery, there has always been the fear that cutting into the head will damage the brain. But the laser stops as soon as it hits the tissue."
Lasers have been used for several years for shattering kidney stones and removing scars. But until now it was not thought they were able to cut through hard tissue such as bone.
"For some time we have been able to plan on computers down to the last millimetre where bones need to be moved to, but it was always hard to translate this into reality when using a saw. With the laser, we can get that precision," Dr Lloyd said.
The trials on the Erbium-Yag laser started last year, first on animals and then on cadavers.
The researchers, who built the laser from scratch, had been concerned at studies in America on similar machines that appeared to show that cuts made by lasers took longer to heal than those made by traditional methods.
Terry King, professor of physics at Manchester University, had studied the American trials but felt that the laser caused such minimal damage to the bone that there was no reason for the healing not to be normal.
Trials at Manchester last summer showed that this was the case. They also showed that the cells surrounding the bones were not affected, as had been at first feared.
Dr Lloyd said: "It has been so long in the developing stage and there have been so many
setbacks that I keep forgetting it is exciting, but then when I tell people about it they say it is amazing, and it is really."
One of the greatest problems the researchers had to overcome was the melting of the fibreoptics, which were not strong enough to cope with the power needed to cut into the bone.
They have overcome this by developing an articulated arm through which the lase passes into a handpiece the size of a pen.Dr Lloyd estimates the machine will cost between £60,000 and £70,000. It is expected to be in use by the end of this year.
"I see a lot of people who either have congenital facial deformities or whose faces have been severely damaged in traffic accidents," he said."I think this will revolutionise surgery."
