Photonics & Lasers in Medicine – Dissolved in diversity

It has been more than 50 years since Theodore Maiman first presented the pulsed laser beam in public. Since then this unique energy source – namely, light amplification by stimulated emission of radiation (LASER) – has initiated a new age in surgery and medicine. In the early years after its invention only a relatively small group of international clinicians and researchers were engaged in the development of improved surgical procedures and clinical therapies that were advantageous for those patients who either could not be treated successfully in a conventional way, or could be treated better than before by using LASER. Driven by these developments, national laser societies were formed, such as the American Society for Laser Medicine and Surgery (ASLMS) and the German Society for Laser Medicine (DGLM), followed by the first international society, the International Society for Laser Surgery and Medicine (ISLSM). As a result, within 10 years the number of medical LASER users increased to several thousand worldwide. In the following decades laser surgery and medicine developed into remarkable stage with an ever-increasing number of applications. It is a technique that is used to transport energy to ablate, coagulate or alter tissue photomechanically or photochemically, as well as to change function or elucidate specific information from the tissue; all these methods allow its multidisciplinary use – with steady growth. The LASER is now well established in many medical disciplines and it has found general acceptance by national and private health plans. Currently diagnostic and therapeutic applications are being developed with different speed. While laser diagnostics research is leading the field, only a few therapeutic techniques have made the leap from bench to bedside lately. It is interesting to note here that a considerable number of LASER and biophotonic techniques have already been integrated into the medical guidelines and that they are being discussed within the medical disciplines rather than within the biophotonics community. However, the amount of research regarding LASER and biophotonics in medicine is steadily increasing, in that the users and their aims are as diverse as they ever were. Within this process, laser medicine and biophotonics are not only related to clinical application. There are many research fields but only a few key applications, with other competitive technologies also on the increase. Reimbursement of costs by social welfare schemes still remains a critical point and industrial investment and research funding are not enough to bridge the gap between the bench and the bedside. In spite of this, there have been many optical innovations in laboratory medicine, histology and pathology, LASER and light applications, and diagnostic procedures.