# Introduction asers have extensive application in medical sciences today but unfortunately the cost of medical Lasers is exorbitant and it is beyond the capacity of an average doctor to afford it. To solve this problem, I did my own research and developed low cost medical Laser which most of the doctors can afford. # II. # Aims and Objectives To develop a cost-effective medical laser for vast majority of medical applications such as lithotripsy, photocoagulation, cauterization, Laser tissue welding etc. # III. echnology 20-watt 950 nm ND: YA Gdiode laser machine: (Photo 2,4) It was made by coupling a 0.1 mm optical fiber (Photo 1) to a 20-watt 950 nm ND YAG diode laser(Photo 3). Photo 4 shows the interior of the machine showing Laser diode with cooling fan and power supply and exhaust fan. The machine has a foot switch to precisely control the on and off function. It has a power control nob which controls power from 0-20 Watts. The fiber is detachable from the main machine. It can be detached and sterilized by putting in Formalin chamber or by Ethylene Oxide gas. Patent is applied at Mumbai office for this invention. A Laser Diode (Photo 3) is a semiconductor device similar to a light-emitting diode (LED). It uses p-n junction to emit coherent light in which all the waves are at the same frequency and phase. This coherent light is produced by the laser diode using a process termed as "Light Amplification by Stimulated Emission of Radiation", which is abbreviated as LASER. And since a p-n junction is used to produce laser light, this device is named as a laser diode. Neodymium-doped yttrium aluminum garnet (Nd: YAG) is a crystal that is commonly used as a lasing medium for solid-state lasers. J. E. Geusic et al first explained the laser operation of Nd: YAG at Bell Laboratories in 1964. Nd: YAG is formed by replacing a small quantity of yttrium ions in the YAG crystal structure with triply ionized neodymium that serves as a dopant. The ions are replaced due to the fact that they are of same size. The neodymium ion acts as the lasing medium in the Nd: YAG crystal. Nd: YAG laser consists of a four-level gain medium that offers extraordinary laser gain at moderate pump intensities and excitation levels. The gain bandwidth of the laser is relatively small, which in turn improves laser's gain efficiency thereby minimizing threshold pump power. It emits infrared light in the range of 1064 nm. It can be lamp pumped or diode pumped. Lamp pumping can be achieved because of the four-level characteristics and broadband pump absorption of the laser in the 800 nm band region. Specifications of laser diode used in this machine are: Output power:20 Watts, continuous type, Waverlength 950 nm,spectral width 6 nm,threshold current 600 mA,Operating current 11 Amp,Operating voltage 5.7 Volt,Operating temperature 25 degree centigrade, life 50,000 hour. Specifications of the fiber used are:Type-single mode, Core diameter 100 micrometer,numeric aperture 0.15, cladding diameter 125 micrometer,buffer diameter 250 micrometer, total outer diameter of jacket 1 mm. # Discussion In oncology, Nd: YAG lasers can be used to remove skin cancers. [11] They are also used to reduce benign thyroid nodules, [12] and to destroy primary and In Dentistry, Nd: YAG dental lasers are used for soft tissue surgeries in the oral cavity, such as gingivectomy, periodontal sulcular debridement, LANAP, pulpotomy, frenectomy, biopsy, and coagulation of graft donor sites. Medical lasers cost in the range of USD 50,000-75,000. It is beyond the capacity to afford particularly in third world countries like India. The machine [Photo1,3] is made in just USD 500 vs market cost of USD 50,000. It is commercialized at a reasonable cost of USD 1000. That makes it the cheapest medical laser in the market in that category. Such an invention is unique and reported for the first time in medical literature. A patent is registered for this innovation at Mumbai office. ND: YAG Laser has vast applications in medical sciences for the treatment of tumors [4] Nd: YAG lasers emitting light at 1064 nm have been the most widely used laser for laser-induced thermotherapy, in which benign or malignant lesions in various organs are ablated by the beam. Other applications are hereditary hemorrhagic telangiectasi a [5], head and neck hemangiomas [6], in surgical gastroenterology [7], for tracheobronchial lesions [8,9] etc. Nd: YAG lasers are used in ophthalmology to correct posterior capsular opacification, a condition that may occur after cataract surgery, and for peripheral iridotomy in patients with acute angle-closure glaucoma, where it has superseded surgical iridectomy. Frequency-doubled Nd: YAG lasers (wavelength 532 nm) are used for pan-retinal photocoagulation in patients with diabetic retinopathy. In certain cases these lasers are also used to treat eye floaters. [10]. secondary malignant liver lesions. [13] [14]To treat benign prostatic hyperplasia (BPH), Nd: YAG lasers can be used for laser prostate surgery-a form of transurethral resection of the prostate. These lasers are also used extensively in the field of cosmetic medicine for laser hair removal and the treatment of minor vascular defects such as spider veins on the face and legs. Nd: YAG lasers are also used to treat Venous Lake lip lesions. [15] Recently used for Dissecting cellulitis of the scalp, a rare skin disease. [16] Using hysteroscopy the Nd: YAG laser has been used for removal of uterine septa within the inside of the uterus. The same 20-watt 950 nm ND: YAG diode laser machine can be used as a cautery machine by adding a laser guide (Photo 5) to the optical fiber. It can be used as an end ocautery in laparoscopy [Photo 6] by adding a long laser guide. The Laser cautery is far more versatile and superior to the conventional electro cautery. Carbon does not form at the tip of the fiber which needs to be cleaned periodically as in electro cautery. Laser cautery is far more precise and damage to surrounding tissues is negligible as compared to electro cautery. The lasers have great photo coagulating properties. Bleeding that does not stop with electro cautery stops with laser cautery. The use of lasers in laparoscopy is quite new. The author has used the machine for breaking bladder, ureteric and kidney stones (Photo 5) and for photocoagulation of facial hemangiomas. The laser was found to be more effective as lithotripter particularly for gall stone which are softer that renal stones. The author has also used the machine for following applications. Laser tissue welding (Photo 8) is a novel technique where 40 % human albumin is put into ( D D D D ) a wound and 5 -Watt Infrared laser of 950 nm is applied over it. At 60-degree centigrade temperature it leads to a formation of a watertight bond of proteins over the tissues by the photo polymerization effect of laser and gives about two weeks of healing in just two minutes. A costly USD 10,000 machine is used for the purpose which is also not commercially available. My laser machine kept at 5-watt power achieved the same result. Tissues such as spleen, liver, pancreas, brain and kidneys where sutures do not hold well are indications for this technique. 3![Photo 3: Laser diode coupled with 0.1 mm optical fiber](image-2.png "Photo 3 :") 45![Photo 4: Showing inner view of the machine-Laser diode with cooling fan and power supply](image-3.png "Photo 4 :Photo 5 :") 6![Photo 6: Laser guide for open surgery](image-4.png "Photo 6 :") 88![Photo 8: Circumcision done with Gluteraldehyde albumin dye induced laser tissue welding Gluteraldehyde Albumin glue Induced Laser Tissue Welding (2), (Photo 8): 0.9 ml 40 % human albumin is taken in 1 ml syringe and mixed with 0.1 ml of 10 % glutaraldehyde solution. The syringe is shaken vigorously to mix both the components. My Laser machine is set at 5 watts power and illuminated over this bond for 60 seconds to polymerize it. It forms a watertight strong bond over the tissues. The technique has vast applications in surgery such as for sealing post-operative wounds, CLW closure, reinforcement of suture line of bowel an astomos is, Bowel perforation, sealing dura repair, hypospadias surgery, urological operations etc.Frenotomy Operation by Methylene blue Dye enhanced Laser Tissue Cutting (3), (Photo 8) This new technique is reported for the first time in the medical literature. Cheap infra-red Lasers do not act on tissues which are of the same color and in fact reflected. To solve this problem, I infiltrated tissues with opposite color Methylene blue which is already FDA approved for use in human body. My Infrared laser now acted only on blue infiltrated areas and saving surrounding tissues of any co lateral damage. Because of the Methylene blue dye, my cheap infrared laser can be used for this purpose. Otherwise, a high frequency 2000 nm and high wattage (40 Watt) laser has to be used which is extremely costly (USD 50,000) and is not affordable to most surgeons. The only disadvantage of laser against electrocautery was cost which is eliminated in this technique. The technique also becomes a foundation as a learning experience for its wider application in other areas of surgery such as Photocoagulation in liver surgery, renal surgery, brain surgery, on pancreas etc.](image-5.png "Photo 8 :Photo 8 :") ![](image-6.png "") ![](image-7.png "") ![](image-8.png "") ![](image-9.png "") © 2020 Global Journals ( )F © 2020 Global Journals * The Expert's Guide to Buying Laser Equipment Louis Silberman * India Open Journal of Urology Online: 2160- 5629. Print: 2160-5440 9 2019 Suture-Less Circumcision by Glutaraldehyde Albumin Glue Enhanced Laser Tissue Welding-A Comparative Study Sagar A. Jawale, Jawale Institute of Pediatric Surgery * Tongue Tie Release Operation (Frenotomy) By Methylene Blue Dye Induced Infrared Laser Cutting Sagar A Jawale 10.31080/ASPE.2019.02.0098 April 29. 2019. June 26. 2019 Jalgaon-Maharashtra, India Received Jawale Institute of Pediatric Surgery Published * Tumour therapy with the Nd:YAG laser SBown Neodymium-YAG Laser in Medicine and Surgery SNJoffe MCMuckerheide LGoldman * Treatment of hereditary hemorrhagic telangiectasia by Nd-YAG laser photocoagulation SMShapshay POliver Laryngoscope 94 1984 PubMedCrossRefGoogle Scholar * Neodymium YAG laser photocoagulation of hemangiomas of the head and neck SMShapshay LMDavid SZeitels Laryngoscope 97 1986 Google Scholar * SNJoffe Contact neodymium: YAG laser surgery in gastroenterology: A preliminary report PubMedCrossRefGoogle Scholar 1986 6 * Treatment of tracheobronchial lesions by laser photoresection J-FDumon EReboud LGarbe Chest 81 1982 Pub Med Cross Ref Google Scholar * Bronchoscopic management of tracheal lesions using the neodymium yttrium aluminum garnet laser LToty CPersonne AColchen 'Vourc G Thorax 36 1981 PubMedCrossR ef Google Scholar * Nd: YAG laser vitreolysis versus pars plana vitrectomy for vitreous floaters JKokavec ZWu JCSherwin AjsAng GSAng 10.1002/14651858.CD011676.pub2.PMC6481890 28570745 Cochrane Database Syst Rev 6 D011676 2017 * K; AMoskalik Kozlov; E Demin * Percutaneous Laser Ablation of Cold Benign Thyroid Nodules: A 3-Year Follow-Up Study in 122 Patients EBoiko ;Valcavi RRiganti FBertani AFormisano DPacella CM 10.1089/thy.2010.0189 20929405 Thyroid 20 11 2009. November 2010 The Efficacy of Facial Skin Cancer Treatment with 12 * CMPacella * GFrancica * DiLascio FM * VArienti * EAntico BCaspani FMagnolfi ASMegna * Long-term outcome of cirrhotic patients with early hepatocellular carcinoma treated with ultrasound-guided percutaneous laser ablation: a retrospective analysis MPretolani S; Regine R; Sponza RStasi 10.1200/JCO.2008.19.0082 19332729 Journal of Clinical Oncology 27 16 June 2009 * MPompili CMPacella G;Francica MAngelico * GTisone PCraboledda ENicolardi GLRapaccini * Percutaneous laser ablation of hepatocellular carcinoma in patients with liver cirrhosis awaiting liver transplantation GGasbarrini 10.1016/j.ejrad.2009.03.012 19345541 European Journal of Radiology 74 3 June 2010 * LAzevedo VGalletta * EduardoDe Paula * Venous Lake of the Lips Treated Using Photocoagulation with High-Intensity Diode Laser DMigliari 10.1089/pho.2009.2564.PMC2957073 19811083 Photomedicine and Laser Surgery 28 2 2010 * BDKrasner FHHamzavi GJMurakawa * Dissecting cellulitis treated with the long-pulsed Nd: YAG laser IHHamzavi 10.1111/j.1524-4725.2006.32227 16918566 Dermatologic Surgery 32 8 August 2006