Ureteroscopy with Holmium: YAG Laser—A Initial Study in the Urology Department of the Pr Bocar Sidy Sall University Hospital of Kati

Introduction: Ureteroscopy is a minimally invasive endoscopic surgery which provides access to the ureter, pyelon and calyceal cavities via the urethra and the bladder. Laser ureteroscopy uses the laser as an energy source to treat the stone and eliminate it naturally. Minimally invasive endoscopic methods are struggling to become popular in sub-Saharan African countries, especially for the upper urinary tract. The objective of our work was to report the results of our first laser ureteroscopy experience in the department. Materials and Methods: This was a prospective and descriptive study running from December 1, 2023 to February 19, 2024. Included in our study was any case of upper urinary tract stone operated by Laser ureteroscopy. The characteristics of the lithiasis were determined by CT scan. Sterilization of urine was verified by carrying out a cytobacteriological examination of urine. Ureteral lithiasis was approached by semi-rigid ureteroscopy. Renal lithiasis was immediately addressed by flexible ureteroscopy. Ureteroscopy was coupled with a Holmium YAG laser. A double J ureteral catheter was placed after the operation. A 230 µm laser fiber was used in each case with a generator with a power of 35 watts (Storz Calculase III type). An access sheath was used in all cases of flexible ureteroscopy. The parameters studied were: sociodemographic characteristics, lithiasis (site, size, number, density, topography), type of anesthesia, duration of laser use, duration of intervention, postoperative outcomes. Data entry and analysis were carried out using the software (Word 2016 and SPSS). Result: We collected 30 cases of laser ureteroscopy. The average age was 37 years with extremes of 9 and 79 years. The male gender was more represented. The most common age group was 24-39 years old. Renal colic was the most frequent reason for admission, 12 patients (40%). On physical examination, lumbar tenderness was present in 47% (14 patients). ECBU was positive in 4 patients (13%). CT scan was performed in all our patients before the intervention. The average stone size was 12 mm and the largest was 23 mm. The majority of stones, i.e. 59% (18 patients), had a density greater than 1000 HU. The stone was unique in 19 patients (63%). The location of the stone was pyelic in 8 patients or 27%. An impact on the upper urinary tract was found in 16 of our patients or 53%. General anesthesia was used in 25 patients (83%). A digital flexible ureteroscopy was used in 24 patients and a semi-rigid ureteroscopy (URS) in 6 patients. Full-course fragmentation was the most used therapeutic method, 9 patients or 32%. The average duration of interventions was 61 minutes. Drainage by double J catheter at the end of the procedure was performed in all our patients. The length of hospitalization was 24 hours. Only one case of failure in the USSR was recorded, and one case of failure was in the semi-rigid URS. Conclusion: Laser ureteroscopy is an effective minimally invasive surgery in the management of lithiasis of the upper urinary tract. It significantly reduces the length of hospitalization. Mastery of this technique and the acquisition of the equipment necessary for its implementation is an undeniable asset in the management of renal and ureteral lithiasis.

Nd:YAG water mist laser treatment for giant gestational gingival tumor: A case report

BACKGROUND This case of gestational gingival tumor is huge and extremely rare in clinical practice.As the growth location of this gingival tumor is in the upper anterior tooth area,it seriously affects the pregnant woman's speech and food,causing great pain to the patient.The use of Nd:YGA water mist laser to remove the gingival tumor resulted in minimal intraoperative bleeding,minimal adverse reactions,and good postoperative healing,which is worthy of clinical promotion and application.CASE SUMMARY The patient,a pregnant woman,reported a large lump in her mouth on the first day of postpartum treatment.Based on medical history and clinical examination,the diagnosis was diagnosed as gestational gingival tumor.Postoperative pathological biopsy also confirmed this diagnosis.The use of Nd:YAG water mist laser to remove the tumor resulted in minimal intraoperative bleeding,clear surgical field of view,short surgical time,and good postoperative healing.CONCLUSION In comparison to traditional surgery,Nd:YAG water mist laser surgery is minimally invasive,minimizes cell damage,reduces bleeding,ensures a clear field of vision,and virtually eliminates postoperative edema,carbonization,and the risk of cross infection.It has unique advantages in oral soft tissue surgery for pregnant patients.Therefore,the clinical application of Nd:YAG water mist laser for the treatment of gestational gingival tumors is an ideal choice.

新型Nd:YAG激光治疗中老年玻璃体混浊患者的视觉质量评价研究

目的通过新型Nd:YAG激光治疗中老年玻璃体混浊患者的视觉质量评价研究,评估新型Nd:YAG激光治疗玻璃体混浊的疗效及应用价值。方法本研究为前瞻性观察性队列研究,本研究共筛选入组47例患者54只眼,其中男性20例,女性27例,年龄30~81岁,平均年龄(58.32±10.38)岁。所有患者术前进行最佳矫正视力(BCVA)、眼压、眼B超、超广角扫描激光眼底照相、裂隙灯散瞳眼底检查、光相干断层扫描(OCT),评估患者玻璃体混浊的位置及玻璃体后脱离情况。术后2周、4周随访,记录BCVA、眼压、眼底情况。采用配对t检验方法比较治疗前后BCVA、眼压的变化,P<0.05为差异有统计学意义的标准。结果Nd:YAG激光术前患者BCVA为0~1.0,平均为(0.18±0.27),眼压为10~20mmHg,平均为(14.84±2.22)mmHg。术后4周患者BCVA为0~1.0,平均为(0.17±0.25),眼压为9~19mmHg,平均为(14.30±2.39)mmHg。统计学分析发现,术前术后视力变化无显著性差异(P=0.129),但术后眼压轻度下降,差异有统计学意义(P=0.015)。术后4周患者视觉质量满意度评价平均分为5~10分,平均为(8.10±1.18)分。82%的患者术后3天内黑点增多,98%的患者术后2周眼前遮挡黑影消失,96%的患者术后4周视觉质量明显改善。结论经新型Nd:YAG激光治疗后的中老年玻璃体混浊患者,飞蚊症症状改善明显,患者视觉质量满意度高,尤其是伴有明显weiss环患者,患者的视觉质量改善显著。

Stability of neodymium:YAG laser posterior capsulotomy in eyes with capsular tension rings

·AIM: To evaluate the stability of neodymium(Nd):YAG laser posterior capsulotomy in eyes with capsular tension rings(CTRs).·METHODS: A total of 60 eyes that underwent cataract surgery and laser posterior capsulotomy postoperatively were included in this retrospective cohort study. To evaluate the safety and stability of capsulotomy, changes in the size of posterior capsulotomy and anterior chamber depth(ACD) in three groups: the group without CTR, the group with 12 mm CTRs, and the group with 13 mm CTRs, at 1wk, 3, 12, and 15mo after capsulotomy, were compared. ·RESULTS: In the group without CTR and the group with 12 mm CTR, there was no significant change in ACD at every post-laser follow-up. In the group with 13 mm CTR, the ACD change was significant until 3mo after capsulotomy. In all groups, there was a significant increase in the area of capsulotomy between 1wk and 3mo post-laser. Between 3 and 12mo post-laser, only the group with 13 mm CTR showed a significant increase in the area of capsulotomy(P<0.01). ·CONCLUSION: Laser posterior capsulotomy is safe in all three groups. The capsulotomy and ACD become stabilized and have not shown significant changes since 1y postlaser, even with larger CTRs. The maintenance of centrifugal capsular tension can last longer with larger CTRs, and the stability of the capsulotomy site can be reached about 12mo after capsulotomy in pseudophakic eyes with larger CTRs.

Long-term efficacy and safety of YAG laser vitreolysis for vision degrading myodesopsia

AIM:To assess the long-term efficacy and safety of yttrium-aluminum garnet(YAG)laser vitreolysis for vision degrading myodesopsia(VDM)caused by posterior vitreous detachment(PVD).METHODS:This retrospective study reviewed VDM patients of PVD type undergoing YAG laser vitreolysis.The baseline demographic information,the patterns of floaters,the number of floaters,and the subjective improvement of floater sympotoms(ranging from 0 to 100%)from medical records were collected.Significant improvement was defined as a relief of floater symptoms of≥50%at the final visit.The long-term efficacy and safety of YAG laser vitreolysis were analyzed.The risk factors linked to significant improvement of floater symptoms were defined using univariate and multivariate logistic regression analyses.RESULTS:The final analysis included 221 patients with VDM.The mean age of patients was 61.08±7.74y,and the mean length of follow-up was 21.38±5.61mo.Totally 57.01%of patients experienced a significant improvement in their floater symptoms after YAG laser therapy,and none of them developed delayed retinal abnormalities such as retinal tears or detachments.Age(OR=1.049,95%CI=1.007-1.092,P=0.021)was identified as a significant risk factor for significant improvement in VDM.CONCLUSION:YAG laser vitreolysis is an effective and secure treatment for PVD-type VDM,and patients of advanced age are more likely to get favorable outcomes.

宽温区Yb∶YAG板条激光模块热畸变仿真研究

本文对不同冷却温度下的Yb:YAG晶体板条激光模块高功率运转时的温度场、应力场及对应的热畸变进行了仿真分析研究。结果显示,随着冷却温度从300 K降低至77K,板条的温度梯度热应力与应变都明显降低。当冷却温度为77 K时,最大主应力为4.14 MPa,仅为常温时的15.6%,最大主应变为3.82×10^(-5),仅为常温时的6%。为了分析Yb:YAG晶体板条激光模块不同冷却温度下输出激光的光束质量,以确定其最佳运转温度,我们采用光线追迹的方法,对单程通过板条的1030 nm探测光进行仿真。可以看到,当冷却温度为77 K时,远场光斑能量更为集中,且探测光光程差的PV值为0.7941μm,仅为300 K时的59.6%。模拟结果表明低温运转有利于Yb:YAG晶体板条激光模块产生高功率高光束质量激光输出,这为高功率高光束质量Yb:YAG晶体板条激光的设计工作奠定了基础。

LD环状侧面均匀泵浦Nd∶YAG激光振荡器

激光二极管(Laser Diode,LD)环状侧面均匀泵浦的激光振荡器具有结构简单、光束质量高、单脉冲能量大等特点,常常在高能脉冲固体激光器中作为主振荡功率放大(MOPA)结构的振荡器,一直是国内外科研人员研究的重要方向之一。本论文通过Zemax软件对不同激光二极管排列方式以及不同工作物质吸收系数对吸收光场的影响的进行了仿真。基于仿真结果,设计了一种20个bar条串联的环状侧面泵浦结构,以提高晶体吸收的均匀性。通过该环状侧泵结构,结合超高斯非稳腔设计,搭建了一种双棒串接激光振荡器进行实验研究。该振荡器实现了在100 Hz重复频率下,单脉冲能量为496 mJ、脉冲宽度为12.4 ns的1064 nm激光输出,光束质量优于9 mm·mrad,光-光转换效率为18.5%。并且该振荡器可以维持光轴稳定不变的同时,实现20 ns脉宽以内变档可调。实验结果证明了该环状侧面均匀泵浦结构可靠有效,为MOPA结构振荡器选取提供了一种有效的方案。

Ureteroscopic Holmium:YAG Laser Lithotripsy for Managing Ureteral Calculi (A Report of 168 Cases)

Summary: The effectiveness and safety of ureteroscopic holmium:YAG laser lithotripsy for managing ureteral calculi was evaluated. Ureteroscopic holmium:YAG laser lithotripsy was performed in 168 ureteral calculi (upper 27 cases, middle 33 cases and lower 108 cases). The results showed that the stone-free rate was 92.6 % in the upper ureteral calculi, 93.9 % in the middle ureteral calculi and 94.4 % in the lower ureteral calculi, respectively. The complication rate was 4.8 % (8 cases). It was suggested that ureteroscopic holmium:YAG laser lithotripsy is a highly effective and safe treatment modality for managing ureteral calculi.

Er∶YAG激光SWEEPS双脉冲模式激活荡洗在自由水域中的气泡动力学观测

目的:探究Er∶YAG激光光子增强的光声流(SWEEPS)技术在不同脉冲间隔参数条件下的蒸汽气泡动力学效应。方法:Er∶YAG激光手具连接工作尖放置于自由水域模型中,设置SWEEPS模式,150~600μs脉冲间隔激活。高速摄像机(200 000 Hz)摄录Er∶YAG激光激活荡洗引起空穴效应的过程,matlab逐帧分析蒸汽气泡间的相互作用关系,及蒸汽气泡消失时刻气泡残余与激光工作尖之间的距离。实验数据经SPSS 19.0统计软件进行统计分析。结果:在自由水域中,Er∶YAG激光SWEEPS模式下,脉冲间隔设置的改变会引起两次脉冲激发的蒸汽气泡形成不同的相互作用关系,包括双气泡融合、双气泡撞击及双气泡脱离。其中,脉冲间隔设置为360~440μs时,双气泡撞击现象会使蒸汽气泡消失时气泡残余与激光工作尖之间达到最远距离。结论:在自由水域中,Er∶YAG激光双脉冲SWEEPS模式在不同的脉冲间隔设置下引起双气泡间形成不同的作用关系,该现象可能可以增强Er∶YAG激光空穴效应,强化激光激活荡洗的临床应用效果。

Treatment of Special Renal Colic with Ureteroscope and Holmium YAG Laser

Objective To investigate the method of emergent relief of special renal colic and treatment of ureter diseases causing renal colic. Methods By analyzing 63 cases of special renal colic treated with ureteroscope and Holmium YAG laser. Results 61 cases of renal colic were relieved in a short period of time and the original ureter diseases causing renal colic were cured. Conclusion Special renal colic could be treated with ureteroscope and Holmium YAG laser in a quick and effective manner.

A method for reducing thermal injury during the ureteroscopic holmium laser lithotripsy

Objective:Many studies have demonstrated the heat effect from the holmium laser lithotripsy can cause persistent thermal injury to the ureter.The purpose of this study was to elucidate the use of a modified ureteral catheter with appropriate firing and irrigation to reduce the thermal injury to the“ureter”during the ureteroscopic holmium laser lithotripsy in vitro.Methods:An in vitro lithotripsy was performed using a modified catheter(5 Fr)as the entrance for the irrigation and the holmium laser fiber while using the remaining space in the ureteroscopic channel as an outlet.Different laser power settings(10 W,20 W,and 30 W)with various firing times(3 s,5 s,and 10 s)and rates of irrigation(15 mL/min,20 mL/min,and 30 mL/min)were applied in the experiment.Temperature changes in the“ureter”were recorded with a thermometer during and after the lithotripsy.Results:During the lithotripsy,the local highest mean temperature was 60.3℃ and the lowest mean temperature was 26.7℃.When the power was set to 10 w,the temperature was maintained below 43℃ regardless of laser firing time or irrigation flow.Regardless of the power or firing time selected,the temperature was below 43℃ at the rate of 30 mL/min.There was a significant difference in temperature decrease when continuous 3 s drainage after continuous firing(3 s,5 s,or 10 s)compared to with not drainage(p<0.05)except for two conditions of 0.5 J×20 Hz,30 mL/min,firing 5 s,and 1.0 J×10 Hz,30 mL/min,firing 5 s.Conclusion:Our modified catheter with timely drainage reducing hot irrigation may significantly reduce the local thermal injury effect,especially along with the special interrupted-time firing setting during the simulated holmium laser procedure.

Analysis of the effect of holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts

Objective:To explore the efficacy,safety,and feasibility of holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts.Methods:From September 2012 to February 2019,a total of 18 patients,aged from 28 to 62(meanstandard deviation[SD]:46.50±9.14)years,were diagnosed with parapelvic renal cysts and treated by holmium laser flexible ureteroscopic intrapelvic drainage.There were 10 males and eight females.All of the parapelvic renal cysts were unilateral,and two cases were complicated with pyelolithiasis.The diameters of the cysts ranged from 4.1 cm to 8.2 cm.Results:All the patients completed the operation successfully in one stage without conversion to open surgery;in two cases,it was difficult to find the cysts during the operation,and the localization was completed by B-ultrasound and percutaneous injection of methylene blue.The mean operative time was 33.89(SD:9.68;range:22-54)min,and the mean hospitalization time was 2.67(SD:0.91;range:2-5)days.Three months and 6 months of follow-up were performed after surgery.The cysts disappeared in 13(72%)cases,and the diameter of the cysts in five(28%)cases decreased by more than 50%.Conclusion:Holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts is simple,safe,and effective,and can be used as the first choice for the treatment of parapelvic renal cysts.

双波长LD泵浦Nd^(3+)∶YAG免温控被动调Q激光器的研究

传统的固体激光器体积、重量大,功耗高,限制了其在空间受限设备中的应用。被动调Q的LD泵浦免温控固体激光器省去了复杂的温度控制装置,调Q机构简单,能够满足复杂温度环境的特殊应用场景的小型化、低功耗要求。提出了基于双波长LD泵浦实现宽温度范围免温控阈值自适应的1.06μm激光脉冲输出方法。基于Nd∶YAG晶体设计了角锥棱镜谐振腔,仿真分析了LD泵浦源到激光棒的面心距对热负载的影响,并确定4 mm的最佳面心距。数值分析了相同泵浦功率下-40~60℃温度范围内激光静态能量输出变化,以及不同初始透过率的可饱和吸收体对激光阈值脉宽的影响。计算结果表明在-37℃~60℃范围内,阈值脉宽都在200μs以下,阈值脉宽最低点达到了29.4μs。构建主波实时探测的阈值自适应调节装置并搭建实验系统,实验结果表明,在温度范围为-35~60℃时,阈值脉宽变化范围为40~180μs。采用激光腔体一体加工成型,应用轻量化的铝合金材料,实现工程化应用,体积83.5 mm×44 mm×29.5 mm,重量约为230 g。在23.8%初始透过率的饱和吸收体条件下实现单脉冲输出能量42 mJ,脉冲宽度5.2 ns。

芪参补气活血养颜汤联合Q开关Nd∶YAG激光治疗女性黄褐斑的美学效果观察

目的:探讨芪参补气活血养颜汤联合Q开关Nd∶YAG激光治疗女性黄褐斑的美学效果。方法:选取笔者医院2019年1月-2022年1月收治的80例黄褐斑女性作为研究对象,按照随机数字表法分为观察组42例(采用芪参补气活血养颜汤联合Q开关Nd∶YAG 1064 nm激光治疗)和对照组38例(采用Q开关Nd∶YAG 1064 nm激光治疗)。观察两组的临床疗效,中医症状积分,皮肤状况,黄褐斑面积及颜色,不良反应发生率。结果:治疗后,观察组患者的总有效率为97.62%,高于对照组患者的84.21%(P<0.05)。治疗后,观察组患者情绪低落、胸胁胀痛、经行乳胀、口苦咽干等上述中医症状积分均低于对照组患者(P<0.05)。治疗后,观察组黑素指数、红斑指数及皱纹指数均低于对照组(P<0.05)。治疗后,观察组黄褐斑面积及颜色评分均低于对照组(P<0.05)。治疗后,观察组患者的总不良反应发生率与对照组患者比较差异无统计学意义(P>0.05)。结论:芪参补气活血养颜汤联合Q开关Nd∶YAG1064 nm激光能够提高黄褐斑治疗的临床疗效,改善患者临床症状,改善皮肤状况,减少黄褐斑面积及颜色,安全性较高,值得临床推广。

Primary prostate Burkitt's lymphoma resected with holmium laser enucleation of the prostate:A rare case report

BACKGROUND Primary prostate Burkitt's lymphoma is a rare and aggressive condition with a poor prognosis.Its clinical presentation can be challenging to differentiate from benign prostatic hyperplasia.Given the rarity of primary prostate Burkitt's lymphoma,its diagnosis and treatment remain unclear.CASE SUMMARY This report presents a case of a 57-year-old male with primary prostate Burkitt's lymphoma,initially misdiagnosed as prostatic hyperplasia.This case's operative process,intraoperative findings and postoperative management are discussed in detail.CONCLUSION Primary prostate lymphoma is difficult to distinguish from other prostate diseases.Holmium laser enucleation of the prostate(HoLEP),a minimally invasive procedure,is crucial in diagnosing and treating this rare disease.Clinicians should remain vigilant and thoroughly combine physical examination,imaging and test results when encountering patients of younger age with small prostate size but a rapid progression of lower urinary tract symptoms.HoLEP is an essential diagnostic and therapeutic tool in managing primary prostate Burkitt's lymphoma.

Efficacy and Safety of Alexandrite and Nd:YAG Laser Combination in Permanent Hair Removal

Background and Objective: Unwanted hair growth is a discomforting issue affecting both genders. People have tried various methods to get rid of this situation. This study aims to evaluate the efficacy and safety of a combined Alexandrite and Nd:YAG laser treatment for permanent hair removal, drawing insights from existing literature. Materials and Methods:This study included a total of 2127 patients (302 males, 1825 females) aged 18 - 65, with complete data, who underwent hair removal treatment between December 2018 and April 2021. These patients were treated using the Duetta laser system (Quanta system, Samarate, Italy), combining Alexandrite 755 nm and Nd:YAG 1064 nm wavelengths. The patients’ skin types were classified according to the Fitzpatrick classification scale. Target area/areas for laser hair removal was/were determined. Laser parameters, pulse counts, pain levels assessed through the Visual Pain Scale (VPS), and patient satisfaction were documented based on skin types. Findings: Across various skin types, Types I - II exhibited the highest treatment success rates (87%), with the axillary region achieving the highest rate (83%) and the face region achieving the lowest rate (75%). Pain scale analysis indicated that 98% of patients tolerated the procedure well. Patient satisfaction levels exceeded 90%. Evaluation of complication rates revealed minimal occurrences. Conclusion: The combined Alexandrite and Nd:YAG laser system demonstrates both efficacy and safety across diverse skin types, attributed to its notable success rates, minimal adverse effects, and high patient tolerance.

基于零声子线泵浦的高效率Yb∶YAG薄片激光器

高功率激光器在工业应用领域的需求不断增长,提高光-光转化效率是降低其生产制造成本的关键途径。针对提高激光器光-光转化效率所面临的增益介质的热负荷问题,利用锁定波长的969 nm“零声子线”泵浦、自主研制的高性能Yb∶YAG薄片晶体和48冲程泵浦系统等,搭建了高效的连续Yb∶YAG薄片激光器系统,实现了最高输出功率373 W,光-光转化效率可达73.37%。其优异性能为后续开展千瓦级超快Yb∶YAG薄片激光器研究奠定了基础。

Flexible ureteroscopic treatment of kidney stones: How do the new laser systems change our concepts?

Objective: Flexible ureteroscopy (fURS) has become a widely accepted and effective technique for treating kidney stones. With the development of new laser systems, the fURS approach has evolved significantly. This literature review aims to examine the current state of knowledge on fURS treatment of kidney stones, with a particular focus on the impact of the latest laser technologies on clinical outcomes and patient safety.Methods: We conducted a search of the PubMed/PMC, Web of Science Core Collection, Scopus, Embase (Ovid), and Cochrane Databases for all randomized controlled trial articles on laser lithotripsy in September 2023 without time restriction.Results: We found a total of 22 relevant pieces of literature. Holmium laser has been used for intracavitary laser lithotripsy for nearly 30 years and has become the golden standard for the treatment of urinary stones. However, the existing holmium laser cannot completely powder the stone, and the retropulsion of the stone after the laser emission and the thermal damage to the tissue have caused many problems for clinicians. The introduction of thulium fiber laser and Moses technology brings highly efficient dusting lithotripsy effect through laser innovation, limiting pulse energy and broadening pulse frequency.Conclusion: While the holmium:yttrium-aluminum-garnet laser remains the primary choice for endoscopic laser lithotripsy, recent technological advancements hint at a potential new gold standard. Parameter range, retropulsion effect, laser fiber adaptability, and overall system performance demand comprehensive attention. The ablation efficacy of high-pulse-frequency devices relies on precise targeting, which may pose practical challenges.

Use of Holmium:Yag laser in early stage oropharyngeal squamous cell cancer

AIM: To evaluate the efficacy of Holmium:Yag laser resection for oropharyngeal squamous cell cancer.METHODS: A prospectively collected case series of all patients with oropharyngeal squamous cell carcinoma undergoing laser resection using the Holmium:Yag laser technique only over a 15 year period at a tertiary referral centre. All patients underwent long term follow up with regular clinical and radiological surveillance, when indicated. All patients were operated on under general anaesthetic with a laser-safe endotracheal tube. Typically laser resection was performed first using an operating microscope, followed by neck dissection. The tumour was held with a Luc's forceps or Allis clamp. The Holmium:Yag laser was implemented via a fibre delivery system. The Holmium:Yag laser fibre, of 550 micron diameter, was inserted through a Zoellner sucker and attached via steri-strips to a second Zoellner suction to provide smoke evacuation. The settings were 1J/pulse, 15 Hz, 15 W in a continuous delivery modality via a foot pedal control. The procedure is simple, bloodless, effective and quick. All surgeries were performed as day cases. RESULTS: Twenty-seven oropharyngeal squamous cell cancer patients were identified, at the following subsites:23 lateral pharyngeal wall/tonsil, 2 anterior faucal and 2 tongue base. Of the 23 tonsil tumours,19 required no further treatment(83% therefore had negative histopathological margins) and 4 required chemoradiotherapy(17% were incompletely excised or had aggressive histopathological features such as discohesive, perineural spread, vascular invasion). The 2 patients with anterior faucal pillar neoplasia needed no further treatment. Both tongue base cancer cases required further treatment in the form of chemoradiotherapy(due to positive histopathological margins). Postoperatively, patients complained of pain locally, which resolved with regular analgesia. There were no postoperative haemorrhages. Swallowing and speech were normal after healing(10-14 d). There was one case of fistula when neck dissection was carried out simultaneously; this resolved with conservative management. All patients were followed up with serial imaging and clinical examination for a minimum of five years. Median follow up was 84 mo.CONCLUSION: Holmium:Yag lasers are a safe and effective treatment for Stage 1 and 2 squamous cell carcinoma of the oropharynx, excluding the tongue base.