Surgery is built on a kind of paradox: In order to heal trauma, doctors must first create more trauma. A broken knee must first turn into a cut-open, exposed, and weaker knee so surgeons can remove the damaged components to make room for stronger replacements. But what if knives weren’t necessary?

Setting A New Gold Standard

The study of blending light with tissues is known as biophotonics. As medicine and science converge in their reliance on technology, growing bodies of evidence suggest the regular use of scalpels may become a grisly relic of the past — a vestige of another time in the same way bloodletting and lobotomies have fallen out of existence. From baldness cures to (literal) windows into the mind, lasers are shifting course from science fiction to plain old science.

Take brain surgery. Unlike skin cancer, which is as easy to treat as it is to detect, if doctors want to find all of the tumors located in a patient’s brain, simply looking at the brain isn’t a luxury they’re afforded. So, they turn to proxies. They have to take a biopsy, freeze it, stain it, and wait for any malformations to crop up. And even after they detect what they think are all potentially harmful tumors, they still can’t be sure if they got everything. The best they can do is wait and see.

At least, that’s the best they can do for now. Last year, neuroscientists from Harvard University and the University of Michigan published a study revealing the effectiveness of a new laser-based “scalpel.” According to their report, the scalpel relies on a phenomenon known as Raman scattering, in which a light that’s shined on an object can reveal its chemical composition. In the brain, tumors have a different cellular structure than the surrounding tissue, so it stands out.

A technique known as Raman scattering produced this image in a mouse's brain. The laser targets chemical composition, turning the tumor blue and the healthy tissue green. Dr. Minbiao Ji, Xie group, Harvard University. Dr. Minbiao Ji, Xie group, Harvard University

For over 100 years, tissue staining has been the “gold standard” for this type of imaging, says co-author Dr. Xiaoliang Sunney Xie, professor of chemistry and chemical biology at Harvard. But the new method is more efficient; it “acts like an optical biopsy, and allows us to identify the tumor margins at a cellular level,” Xie said. “With this paper, we now have the proof of principle that this can be done in human brains in situ."

Lasers In Everyday Life

Lasers’ migration into medical science also has consumer use. The bulk of society’s ailments are day-to-day struggles — tiny, inconvenient, and otherwise benign as far as severity goes. Here, too, lasers are emerging as a helpful alternative, designed to make life easier.

Baldness and diabetes are two good examples. Both come in congenital forms that unfairly remove a valuable piece of personhood: the appropriate production of the glucose-regulating hormone insulin, and hair. Lasers have the answer.

A company in California has produced a new-age helmet that can reportedly stimulate hair growth in the existing follicles that may be thinning. Meanwhile, Princeton University engineers are hard at work on a laser that pierces several layers of skin and interacts with sugar molecules, in an effort to end the all-too-bothersome daily finger prick. The better the molecules absorb the laser, the more glucose there’s likely to be.

And who could forget one of the greatest advances of them all: LASIK. Short for Laser-Assisted in situ Keratomileusis, the procedure has become a life-changing surgery for millions of people whose eyesight afforded them just enough clarity to make out the operation’s hefty price tag. Each year, more than 800,000 refractive surgeries are performed, most of which rely on laser assistance.

The Future

Even as lasers bring the future to the present, some advances are still years, if not decades, away — a good example being transparent skull implants, which scientists can shine a laser through in order to operate. The scientists working on the project, from the University of California, Riverside, say it’s a “crucial first step” toward innovating ways around the invasiveness of partial skull removal, also known as a craniectomy.

Made of the same stuff found in hip implants, the tiny window could let a laser pierce through directly and cover tumors in broad strokes. University of California, Riverside. University of California, Riverside

One of the larger hurdles in getting lasers past the regulatory boards is safety, radiation being the supreme fear. “The efficacy and safety of laser therapeutic devices depend on evaluation of laser irradiation dose,” Ilko Ilev, a senior staff fellow at the Food and Drug Administration Center for Devices and Radiological Health, said at a 2011 conference. “There is a need for standard test methods to improve the accuracy and specificity of laser dosimetry measurements.”

And to be fair, whether people cozy up to the idea of lasers being fired at their skulls, palms, eyes, and scalps is another matter. But like any great leap in scientific discovery, consumers easily fall into the trap of comfort. It’s easy to forget testing strips themselves were a new product at one point, which the diabetic public had to embrace. Now, at least, the stakes aren’t as high.