The Use of Laser Beams for Operations in Haemophilia

Laser beams are light rays of particular intensity. They can concentrate extremely high energies in a minimum of space and time. Since 1978 we use a “Sharplan 791 CO2 -Surgical Laser” for operations on haemophilacs. The edges of the Laser incision show a minimal zone of necrosis, which is sufficient to coagulate the small vessels and to reduce bleeding considerably. Until now we have carried out 21 operations on haemophilic patients with the use of Laser beams. They include 5 synovectomies of the knee joint, 4 synovectomies of the elbow (3 of them with excision of the radial head), 2 excisions of haemophilic pseucotumors, 2 joint fusions, 1 total hip replacement and 7 smaller operations. Our experiences have been favorable up to now. Due to the good haemostasis considerably less antihaemophilic factor VIII is required. In mild haemophilia Laser surgery even enables us to do without substitution at all in some cases. In severe haemophilia it is, of course, impossible to avoid postoperative bleeding. Post-operative substitution, however, can be reduced in dose and duration by 50 percent on average. Considering the invaluable advantage of being able to perform almost “bloodless” operations on haemophiliacs with Laser beams, the disadvantages of the technique - such as the complicated manipulation of the apparatus - are of minor importance.