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This overview describes the main milestones of development and deployment history of laser treatment and laser medical equipment in Russia.
A little more than 50 years since the beginning of use of laser technology in domestic medicine have passed. It should be noted that foreign colleagues have started recording the history of development of this direction in the world [1] for a long time, thus the contribution made by domestic scientists, probably, owing to specifics of life behind "iron curtain" was not properly reflected in the foreign publications. Unfortunately, in our community the history of development and deployment of laser methods of treatment and laser medical equipment in our country has not been systematically recorded. Sketchy, and with temporary inaccuracies, this subject is presented in the issues prepared by Laser Association "Lasers – how it was at the beginning". However many pioneers of the direction have died by now, without having left their memoirs. I would like to systematize available data and to compare how the laser medical direction developed in the USSR and abroad in this publication. Since the material was collected in the limited time boundaries, there are gaps which I urge to fill in.
The first publication about the impact of laser radiation on eyes has appeared the next year after creation of lasers – in 1961 [2]. Same year Leon Goldman has shown that the ruby laser can be used for removal of port-wine stains and melanoma from skin. He has played an important role in the development of laser medical technologies, having founded the American Society for lasers in medicine and surgery (ASLMS), therefore he was named "the father" of use of laser radiation in medicine [3]. The same year Charles J. Campbel from Colombian Presbyterian medical center in New York has welded the exfoliating retina by means of the ruby laser, and the corresponding publication appeared [4] the next year.
In the USSR, the first ruby lasers have been created in 1961, and in 1963 the experimental laser ophthalmoscope coagulator "Dragonfly" was developed in the Moscow experimental design bureau No. 16 headed by A. E. Nudelman (DB Tochmash) [5]. Yu. L. Tversky, V. I. Rybalsky and A. E. Nudelman were given the copyright certificate on the invention with priority as of December 1963 has been granted for the laser ophthalmoscope coagulator (unfortunately, the number of the copyright certificate in [5] is specified incorrectly). After researches of impact of laser radiation on tissues of eyes of animal, in the Odessa Scientific Research Filatov Institute, the USSR’s first operation on human was performed in June, 1964: "welding" of retina of eye by means of radiation of the ruby laser. Doctor L. A. Linnik with the assistance of Yu. L. Tversky and V. L. Reznikov performed the surgery. Further the USSR’s first laser coagulator OK‑1 was developed based on the test apparatus which by the Decision of the USSR MHC Committee for new equipment was put into mass production at the Zagorski optical-mechanical plant in 1965. The leading participants of the development, Yu. L. Tversky and V. I. Rybalsky, were awarded "S.I.Vavilov Prize" for the researches laying the foundation for development OK‑1. In 1973 it was succeeded by OK‑2.
In 1968 Jako who worked with Polianyi from the American optical company performed ablation of polyps of vocal chords using CO2-laser, having carried out the first direct surgical intervention with the use of such laser [1,6]. However, according to [7], the USSR was not far behind in the field of surgical use of carbon dioxide lasers. The country’s first laser scalpel on the CO2-laser (fig. 2) has been developed under the direction of academician N. D. Devyatkov’s in Fryazinsky’s "Source". Here is the way N. D. Devyatkov describes it [7]: "Our developers under the general guide of V. P. Belyaev and with participation of the surgeon professor S. D. Pletnev (P. A. Herzen Moscow Scientific and Research Oncological Institute) finished the development of design of medical laser unit approximately in 1967. It was equipped with mirror manipulator convenient for work of the surgeon with several degrees of tip movement freedom with the optical system enabling to focus the generated beam with a diameter up to 0.3 mm or to defocus it to the bigger size of diameter of radiation stream. Power of continuous radiation at the beam outlet could be regulated from 10 W to several tens of watts".
Further SSPE "Source" has carried out commercial production of laser scalpels "Rowanberry". Unfortunately, I did not manage to find information on further destiny of S. D. Pletnev. As remembered by his grandson, V. P. Belyaev his grandfather visited with his laser scalpel other countries, in particularly, Israel.
The beginning of use CO2-laser scalpels abroad for daily surgical practice is connected with the name of Isaak Kaplan, professor of Tel Aviv University [1]. In 1972 together with the engineer Uzi Sharon he has developed the laser medical unit which has received the name compounded of their surnames – "Sharplan", as well as the company created by them which has existed before the beginning of this century. Over many years, carbon dioxide laser scalpels have become the main tool of laser surgeons. And, probably, thanks to the properties they will remain in arsenal of the doctors for a long time, if not forever.
The Ukrainian colleagues have joined the development of laser scalpels and techniques of their use. The laser unit for treatment of tumors was developed by scientific research institute "Kvant" (Kiev) in 1966–1967 by V. L. Isakov. The radiation of carbon dioxide laser (10.6 microns) with power of up to 50 W and the glass laser activated by Nd (1.06 microns) with pulse energy of up to 1000 J was combined in this unit. It was the first unit where two independently adjustable operating radiations with different lengths of waves were fed through a single channel.
Medical and biological researches with this unit have been conducted in laboratory of laser biology and therapy of tumors of the Kiev scientific research institute of experimental and clinical oncology (nowadays R. E. Kavetsky Institute of experimental pathology, oncology and radiobiology of NAS of Ukraine) headed by N. F. Gamaleya.
By the way, N. F. Gamaleya is the only Soviet scientist, whose pioneer role in the development of laser medical technologies was mentioned in the foreign press (fig.3) as discovered by the author. Apparently, it was promoted by his yearlong work in 1967–1968 in one of the laser medical and biological centers of the USA.
However, the decisive contribution to the development in the direction of laser medical instrument making was made by NPO Polyus thanks to purposeful activity of its creator and the first head M. F. Stelmakh [9, 11]. Today Polyus Research Institute (alas, the remainders of the powerful scientific and production association) bears the name of the founder. It is the association where the laser scalpel under the leadership of B. N. Malyshev was developed in 1970 and "Scalpel‑1" based on continuous CO2-laser (fig. 4) was put to mass production in 1975, which has become real "power horse" in domestic health care. Furthermore, according to medical and technical requirements of the USSR MHC, the laser medical unit "Impulse‑1" has been developed: "Development of the unit was finished in 1971. The same year the USSR MHC Committee on new medical equipment made its recommendation to produce first commercial lot of "Impulse‑1" units which was produced in 1975 at the Sverdlovsk plant of electromechanical equipment" [10]. It has been developed based on the glass laser activated by neodymium with the maximum radiation pulse energy of 1 kJ (fig.5).
Further, the joint development and mass production of laser medical devices of different function has followed. However, the development of medical direction in NPO Polyus which has become the main producer of laser medical equipment in the last decades of existence of the USSR is better described by its direct creators [11]. This work was conducted in close contact with the specialists of the leading medical institutions of the country.
In the USSR, active participation in creation and implementation of laser surgical techniques have been adopted by many eminent persons of domestic medicine (A. A. Arapov, E. I. Brekhov, A. A. Vishnevsky, A. I. Golovnya, N. F. Gamaleya, S. D. Pletnev and many others). However the special role was played by the corresponding member of the Russian Academy of Medical Science O. K. Skobelkin. Being already the mature scientist and surgeon, he has entirely devoted his activity to development, improvement and implementation of laser techniques in health care. Having begun with creation of laboratory of laser surgery in CRL of 4 SA of Ministry of Healthcare of the USSR, he has created and has headed the Institute of laser surgery which has been transformed to the State scientific center of laser medicine of the Russian Ministry of Healthcare.
Under the leadership of O. K. Skobelkin, the school of sciences which has made the significant contribution to development of laser medical technologies has been formed. O. K. Skobelkin and his followers always closely worked with the developers of laser medical equipment, promoting its improvement.
At the turn of the 80th and 90th, there were two different-sized events which have led to NPO Polyus’s loss of its leading positions in the field of laser medical instrument making. It is the collapse of the USSR and the subsequent difficulties in economy and M. F. Stelmakh’s removal from post of Director General of NPO Polyus. But the industry has not died: other organizations, other people have allowed Russia to hold decent international positions. However, it has been already mentioned by the author.
The author expresses gratitude to A. Yu. Belyaev, E. A. Cheshev, G. M. Zverev and A. G. Mikhalchenko who assisted in collecting material.
The first publication about the impact of laser radiation on eyes has appeared the next year after creation of lasers – in 1961 [2]. Same year Leon Goldman has shown that the ruby laser can be used for removal of port-wine stains and melanoma from skin. He has played an important role in the development of laser medical technologies, having founded the American Society for lasers in medicine and surgery (ASLMS), therefore he was named "the father" of use of laser radiation in medicine [3]. The same year Charles J. Campbel from Colombian Presbyterian medical center in New York has welded the exfoliating retina by means of the ruby laser, and the corresponding publication appeared [4] the next year.
In the USSR, the first ruby lasers have been created in 1961, and in 1963 the experimental laser ophthalmoscope coagulator "Dragonfly" was developed in the Moscow experimental design bureau No. 16 headed by A. E. Nudelman (DB Tochmash) [5]. Yu. L. Tversky, V. I. Rybalsky and A. E. Nudelman were given the copyright certificate on the invention with priority as of December 1963 has been granted for the laser ophthalmoscope coagulator (unfortunately, the number of the copyright certificate in [5] is specified incorrectly). After researches of impact of laser radiation on tissues of eyes of animal, in the Odessa Scientific Research Filatov Institute, the USSR’s first operation on human was performed in June, 1964: "welding" of retina of eye by means of radiation of the ruby laser. Doctor L. A. Linnik with the assistance of Yu. L. Tversky and V. L. Reznikov performed the surgery. Further the USSR’s first laser coagulator OK‑1 was developed based on the test apparatus which by the Decision of the USSR MHC Committee for new equipment was put into mass production at the Zagorski optical-mechanical plant in 1965. The leading participants of the development, Yu. L. Tversky and V. I. Rybalsky, were awarded "S.I.Vavilov Prize" for the researches laying the foundation for development OK‑1. In 1973 it was succeeded by OK‑2.
In 1968 Jako who worked with Polianyi from the American optical company performed ablation of polyps of vocal chords using CO2-laser, having carried out the first direct surgical intervention with the use of such laser [1,6]. However, according to [7], the USSR was not far behind in the field of surgical use of carbon dioxide lasers. The country’s first laser scalpel on the CO2-laser (fig. 2) has been developed under the direction of academician N. D. Devyatkov’s in Fryazinsky’s "Source". Here is the way N. D. Devyatkov describes it [7]: "Our developers under the general guide of V. P. Belyaev and with participation of the surgeon professor S. D. Pletnev (P. A. Herzen Moscow Scientific and Research Oncological Institute) finished the development of design of medical laser unit approximately in 1967. It was equipped with mirror manipulator convenient for work of the surgeon with several degrees of tip movement freedom with the optical system enabling to focus the generated beam with a diameter up to 0.3 mm or to defocus it to the bigger size of diameter of radiation stream. Power of continuous radiation at the beam outlet could be regulated from 10 W to several tens of watts".
Further SSPE "Source" has carried out commercial production of laser scalpels "Rowanberry". Unfortunately, I did not manage to find information on further destiny of S. D. Pletnev. As remembered by his grandson, V. P. Belyaev his grandfather visited with his laser scalpel other countries, in particularly, Israel.
The beginning of use CO2-laser scalpels abroad for daily surgical practice is connected with the name of Isaak Kaplan, professor of Tel Aviv University [1]. In 1972 together with the engineer Uzi Sharon he has developed the laser medical unit which has received the name compounded of their surnames – "Sharplan", as well as the company created by them which has existed before the beginning of this century. Over many years, carbon dioxide laser scalpels have become the main tool of laser surgeons. And, probably, thanks to the properties they will remain in arsenal of the doctors for a long time, if not forever.
The Ukrainian colleagues have joined the development of laser scalpels and techniques of their use. The laser unit for treatment of tumors was developed by scientific research institute "Kvant" (Kiev) in 1966–1967 by V. L. Isakov. The radiation of carbon dioxide laser (10.6 microns) with power of up to 50 W and the glass laser activated by Nd (1.06 microns) with pulse energy of up to 1000 J was combined in this unit. It was the first unit where two independently adjustable operating radiations with different lengths of waves were fed through a single channel.
Medical and biological researches with this unit have been conducted in laboratory of laser biology and therapy of tumors of the Kiev scientific research institute of experimental and clinical oncology (nowadays R. E. Kavetsky Institute of experimental pathology, oncology and radiobiology of NAS of Ukraine) headed by N. F. Gamaleya.
By the way, N. F. Gamaleya is the only Soviet scientist, whose pioneer role in the development of laser medical technologies was mentioned in the foreign press (fig.3) as discovered by the author. Apparently, it was promoted by his yearlong work in 1967–1968 in one of the laser medical and biological centers of the USA.
However, the decisive contribution to the development in the direction of laser medical instrument making was made by NPO Polyus thanks to purposeful activity of its creator and the first head M. F. Stelmakh [9, 11]. Today Polyus Research Institute (alas, the remainders of the powerful scientific and production association) bears the name of the founder. It is the association where the laser scalpel under the leadership of B. N. Malyshev was developed in 1970 and "Scalpel‑1" based on continuous CO2-laser (fig. 4) was put to mass production in 1975, which has become real "power horse" in domestic health care. Furthermore, according to medical and technical requirements of the USSR MHC, the laser medical unit "Impulse‑1" has been developed: "Development of the unit was finished in 1971. The same year the USSR MHC Committee on new medical equipment made its recommendation to produce first commercial lot of "Impulse‑1" units which was produced in 1975 at the Sverdlovsk plant of electromechanical equipment" [10]. It has been developed based on the glass laser activated by neodymium with the maximum radiation pulse energy of 1 kJ (fig.5).
Further, the joint development and mass production of laser medical devices of different function has followed. However, the development of medical direction in NPO Polyus which has become the main producer of laser medical equipment in the last decades of existence of the USSR is better described by its direct creators [11]. This work was conducted in close contact with the specialists of the leading medical institutions of the country.
In the USSR, active participation in creation and implementation of laser surgical techniques have been adopted by many eminent persons of domestic medicine (A. A. Arapov, E. I. Brekhov, A. A. Vishnevsky, A. I. Golovnya, N. F. Gamaleya, S. D. Pletnev and many others). However the special role was played by the corresponding member of the Russian Academy of Medical Science O. K. Skobelkin. Being already the mature scientist and surgeon, he has entirely devoted his activity to development, improvement and implementation of laser techniques in health care. Having begun with creation of laboratory of laser surgery in CRL of 4 SA of Ministry of Healthcare of the USSR, he has created and has headed the Institute of laser surgery which has been transformed to the State scientific center of laser medicine of the Russian Ministry of Healthcare.
Under the leadership of O. K. Skobelkin, the school of sciences which has made the significant contribution to development of laser medical technologies has been formed. O. K. Skobelkin and his followers always closely worked with the developers of laser medical equipment, promoting its improvement.
At the turn of the 80th and 90th, there were two different-sized events which have led to NPO Polyus’s loss of its leading positions in the field of laser medical instrument making. It is the collapse of the USSR and the subsequent difficulties in economy and M. F. Stelmakh’s removal from post of Director General of NPO Polyus. But the industry has not died: other organizations, other people have allowed Russia to hold decent international positions. However, it has been already mentioned by the author.
The author expresses gratitude to A. Yu. Belyaev, E. A. Cheshev, G. M. Zverev and A. G. Mikhalchenko who assisted in collecting material.
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