- About IMLAS
Report By Allen T. Brillhart, M.D.
Social: The trip to Germany was a social bonanza. There were castles, beer feasts, great friends and excellent conversation. Everyone involved with this meeting went away with a smile on his or her face. No one was left out. All were entertained at lavish banquets, tours through medieval towns and castles and treated like kings and queens. Our hats have to go off to Werner Siebert, M.D. and his staff from the Orthopaedic Hospital in Kassel. If you have not been keeping up with these international meetings abroad, you are really missing some of the times of your lives. Though this meeting was not as awesome as the meeting in Neuchâtel, it was a close rival. The entire group and their families were even taken to church again.
Academic: From an arthroscopic laser standpoint, this meeting appeared to finally define the Holmium:YAG laser as the one and only laser to be used at this time for arthroscopic laser surgery on practical and routine basis. It did not shut the door, however, to other lasers. Talks from W. Siebert's hospital and his fellow residents on Neodym:YAG photodynamic therapy as well as an excellent paper, which has a great deal of future merit by R. Jackson from Dallas, on the Argon laser stimulation of covalent bonding using a special dye as a co-factor (if you will) for the process was presented. Clinical papers in regards to the use of the Ho:YAG laser clearly defined the lack of association of avascular necrosis found postoperatively with the use of the Ho:YAG laser. O. Atik of Turkey presented the best paper on this topic. P. Hardy of France presented an excellent paper on the advantages of using the Ho:YAG laser for degenerative meniscal tears of the knee. This was probably the most scientific clinical paper presented. W. Siebert presented his follow up of the Ho:YAG laser use through his European study in the knee arthroscopy. No surprises were found. No cases of avascular necrosis were attributed to Ho:YAG laser use. Several other authors presented their case for the use of the Ho:YAG laser in arthroscopic laser surgery without major complications and with excellent results.
For spinal surgery, G. Casper from Oklahoma appeared to have the best information with endoscopic use of the Ho:YAG laser for removing herniated discs. He also complimented A. Bonati, from Tampa, for being a pioneer in this field. A. Bonati was not present at this meeting, but many of his original and controversial techniques have found success. Dr. Choy continues to advocate percutaneous Neodym:YAG laser disc decompression. He feels that this is far superior to the Ho:YAG laser. All in all the spinal section demonstrated much more promise as far as progress is concerned with this new technology than did the field of arthrosocpic laser surgery.
Other uses of the laser for small joints and non-arthroscopic or endoscopic uses were discussed. The best paper on this was presented by B. Gerber from Switzerland. In general, this meeting from an academic standpoint, I would consider as being neutral, but overall the papers pointed to the direction of the continued use and increasing benefits of laser use.