Surgical Division is global leader in surgical laser technology and medical laser equipment, and considered a pioneer in the field of laser for surgery



  Head and Neck

CO2 Laser Microsurgery - When Delicacy and Precision are needed the Most


CO2 Lasers have revolutionized the way otolaryngologists approach surgery, enabling highly precise and, often, less invasive treatment of a wide range of ENT applications.


Unlike open surgery, CO2 lasers can remove cancer with fewer disturbances to structures, nerves, and tissue.


Lumenis’ advanced laser systems enable highly controlled, smart tissue management for treating delicate anatomy and preservation of healthy tissue.


Lumenis’ CO2 technology is associated with clean margins which is one of the most valuable objectives for pathology and malignant surgical procedures as well as patient healing process.


Surgical approach - Transoral Laser Microsurgery


TLM -Transoral laser microsurgery is the most used acronym for CO2 laser endoscopic transoral surgery of the pharynx using the CO2 laser. Lumenis CO2 laser TLM procedure is a synonym for precision. The term TLM is not limited to rigid surgical approach. It also represents flexibility. Surgical approach where compliance to flexible endoscopy and robotic surgery is possible and treating precisely on hard to reach anatomy is achievable.


“TLM is superior to radiotherapy which is often an over-treatment. Oncological results are often better with laser surgery than with radiation. In my experience, there is less local recurrence, and less salvage laryngectomies. Morbidity and complication rates are lower with similar results.”


Wolfgang Steiner, M.D., Professor Emeritus, Department of Otolaryngology, University of Gottingen Medical Center, Germany

TLM as first line treatment


The use of chemotherapy, radiation therapy, or cold knife surgery in the treatment of transoral airway cancer may be associated with complications that can dramatically alter facial appearance. Due to the delicacy and minimally invasive operative method, CO2 lasers are increasingly becoming a first line treatment of early stage airway cancers, especially in the larynx. Studies have demonstrated considerable cost savings and equivalent or better treatment outcomes for transoral laser resection of laryngeal tumors in comparison to radiation.1


TLM Advantages:


  • Precise incision, excision, and vaporization, with microvascular hemostasis
  • Predictable, reproducible laser-tissue interaction
  • Minimal thermal damage for excellent tissue margins
  • Smart margin management and minimal healthy tissue loss
  • Minimal disturbance to structures, nerves, and tissue
  • Multi-option salvage treatments in the event of recurrence
  • Suture-free procedure enables swallowing sooner post-surgery


Learn More about Transoral Laser Microsurgery (TLM) CO2 laser delivery modes:

The Flexible CO2 Fibers and the Digital AcuBlade Scanning Micromanipulator:


Clinical Indications


The versatility offered by the AcuPulse DUO and UltraPulse Duo modules alongside the full suite of CO2 laser fiber and, free beam surgical tools allows you to address a broad range of clinical indications in the operating room and in the outpatient environment. Here is a partial list of indications for use in Head and Neck surgery:


  • Reinke’s edema
  • Benign cycts, nodules and polyps on vocal cords
  • Vocal cords paralysis and motion disorders
  • Recurrent papillomatosis
  • Subglottic and Tracheal stenosis
  • Zenker’s diverticulum
  • Leukoplakia, benign and malignant lesions
  • Enlarged palate, uvula
  • Tonsillectomy
  • Squamous cell carcinoma of the oral cavity and oropharynx


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