Near-infrared semiconductor lasers at 810 nm and 980 nm belong to the moderate-to-high energy laser category. Compared with 650 nm low-power therapeutic lasers, lasers in this wavelength band exhibit significant photothermal effects. By adjusting the output power gradient, they can achieve various functions such as tissue coagulation, hemostasis, cutting, vaporization, and carbonization. Consequently, they are now widely applied in clinical departments including surgery, orthopedics, dermatology, stomatology, otolaryngology, and respiratory medicine. This article focuses on the optical properties and mechanisms of action of 810 nm and 980 nm semiconductor lasers, with a particular emphasis on elucidating the grading of thermal damage (coagulation, cutting, vaporization, and carbonization) in human tissues under different laser power levels. It also reviews clinical application scenarios across these specialties and standardized operating procedures. Furthermore, based on the current technological landscape, future development trends are analyzed to provide references for the standardized clinical use of high-energy semiconductor lasers.

Keywords: semiconductor laser; 810 nm; 980 nm; photothermal effect; tissue cutting; vaporization; carbonization; clinical applications

I.Introduction

       Utilizing semiconductor chips such as gallium arsenide (GaAs) and aluminum gallium arsenide (AlGaAs) as their light-emitting sources, semiconductor lasers have gradually replaced traditional gas lasers to become the mainstream laser equipment for clinical surgery. This transition is attributed to their compact size, high electro-optical conversion efficiency, stable output power, and strong beam controllability. Based on their operational modes, they are classified into low-energy therapeutic lasers and moderate-to-high energy surgical lasers. While 650 nm red lasers are primarily used for non-invasive therapies such as superficial anti-inflammatory treatment, analgesia, and tissue repair, near-infrared semiconductor lasers at 810 nm and 980 nm serve as the core wavelengths for clinical surgical procedures due to their optimal penetration depth in human biological tissues and balanced absorption rates by water and hemoglobin.
        The intensity of the photothermal effect in these two wavelength bands can be precisely controlled by adjusting the output power, operational mode, spot size, and exposure time. Specifically, low power achieves vascular coagulation and hemostasis; medium power facilitates soft tissue dissection and precise cutting; high power induces instantaneous tissue vaporization; and ultra-high power leads to tissue carbonization. Owing to advantages such as simultaneous cutting and hemostasis, clear intraoperative visual fields, minimal trauma, and mild postoperative edema, 810 nm and 980 nm semiconductor lasers have been extensively integrated into scenarios including minimally invasive surgeries, routine surgical operations, and lesion ablation. This article provides a comprehensive review of the mechanisms of action, power-tissue effect relationships, multi-departmental clinical applications, standardized operating protocols, and future development prospects of high-energy semiconductor lasers in this wavelength band.
II. Optical Characteristics and Mechanisms of Action of 810 nm/980 nm Semiconductor Lasers
(I) Fundamental Optical Properties
Human tissues are primarily composed of water, hemoglobin, proteins, and lipids; the absorption capacity of these different substances directly determines the laser’s effects.
  1. 810 nm semiconductor lasers: Located in the near-infrared band, they exhibit a high absorption rate by hemoglobin and relatively mild absorption by water, with a tissue penetration depth of approximately 3–5 mm. The thermal effect is concentrated in the superficial and middle layers of the target tissue. With a limited range of thermal diffusion, this wavelength offers high cutting precision and excellent hemostasis, making it suitable for fine cutting, excision of superficial lesions, and surgeries in highly vascularized areas.
  2. 980 nm semiconductor lasers: Adjacent to the strong absorption peak of water, tissue water exhibits a significantly increased absorption rate for this wavelength, resulting in a penetration depth of about 2–3 mm. Laser energy is more readily absorbed by the tissue surface, leading to faster local temperature elevation, concentrated thermal effects, and stronger vaporization capabilities. This makes it ideal for large-area tissue ablation, resection of hypertrophic tissues, and carbonization treatment of refractory lesions.
Both wavelengths support continuous wave (CW) and pulsed dual-mode outputs, allowing flexible switching to accommodate various surgical requirements—a core feature distinguishing them from therapeutic lasers.
(II) Core Mechanism of Action: Graded Photothermal Effects
The interaction of 810 nm and 980 nm lasers with human tissues is predominantly driven by photothermal effects, while photobiomodulation can be negligible. Once laser photons are absorbed by tissue molecules, they convert into thermal energy. As local temperatures gradually rise with energy accumulation, tissues undergo four typical morphological changes sequentially—coagulation, cutting, vaporization, and carbonization—depending on three variables: output power, exposure time, and spot size. This serves as the core theoretical basis for clinical operations.
  1. Tissue Coagulation (Temperature: 50–60℃, Low Power Range):
    When local temperatures reach 50–60℃, reversible protein denaturation occurs within the tissue, altering cell membrane permeability, causing blood vessel wall contraction and lumen closure. This stage involves no tissue loss and primarily achieves hemostasis, lymphatic sealing, and elimination of exudation. Output power typically ranges from 1 to 10 W. It is mainly used for intraoperative hemostasis, wound bed preparation, and sealing vessels around lesions. Since there is no cutting or vaporization, this acts as a fundamental auxiliary mode during surgery.
  2. Tissue Cutting (Temperature: 60–100℃, Medium Power Range):
    As local temperatures continuously rise to 60–100℃, intercellular connections are disrupted, decreasing tissue elasticity and causing structural rupture. Combined with uniform movement of the laser probe, this enables continuous and smooth tissue separation, known as clinical cutting. The power range is typically 10–30 W. In this range, thermal diffusion is controllable, producing neat incision edges with a thin coagulation layer that simultaneously seals micro-vessels, achieving “cut-and-coagulate” functionality and significantly reducing intraoperative bleeding.
  3. Tissue Vaporization (Temperature: >100℃, Medium-to-High Power Range):
    Once intracellular water reaches its boiling point, it rapidly vaporizes and expands dramatically in volume, rupturing cellular and tissue structures. The target tissue is directly converted into gaseous matter and detached from the wound, forming a tissue defect. This is the primary method for lesion ablation and removal of赘bi (growths), corresponding to powers of 20–30 W. Vaporization is highly precise, clearing diseased tissue layer by layer with minimal damage to surrounding normal tissues. It is widely used for removing hyperplasia, cysts, and warts.
  4. Tissue Carbonization (Temperature: >150℃, High Power Range):
    When power exceeds 30 W, local temperatures rapidly surpass 150℃. Organic matter within the tissue dehydrates and pyrolyzes, precipitating carbon elements and forming a dark brown carbonized layer on the wound. Although this hard layer enhances hemostasis, carbonized tissue loses biological viability. Excessive carbonization delays wound healing and increases postoperative foreign body reactions. Clinically, it is selectively used only for refractory hyperplasia, surface treatment of malignant lesions, and large-area hemostasis, requiring strict control over the application area and duration.
(III) Summary of Effect Differences Between the Two Wavelengths
Under identical power and operational conditions, the 980 nm laser heats up faster, demonstrates superior superficial vaporization and carbonization effects, and has shallower thermal action. Conversely, the 810 nm laser penetrates slightly deeper, creates a wider coagulation zone, and excels in fine cutting and deep hemostasis. Clinicians can flexibly select wavelengths based on the surgical site and tissue type.
III. Tissue Interaction Patterns and Parameter Matching at Different Power Levels
Based on common clinical equipment parameters and using standard handheld fiber optic probes (spot diameter 0.3–0.6 mm), the relationship between power, tissue effects, and applicable scenarios for 810 nm and 980 nm lasers is outlined below to provide guidance for clinical parameter settings:
  1. 1–10 W: Coagulation and Hemostasis Mode
    Effects: Vessel closure and tissue protein denaturation without tissue loss. Applications: Intraoperative hemostasis, management of oozing wounds, and submucosal vessel sealing across various surgeries. Both wavelengths are applicable, with 810 nm preferred for highly vascularized tissues.
  2. 10–30 W: Precision Cutting Mode
    Effects: Tissue separation with neat incisions and a thin peripheral coagulation zone. Applications: Soft tissue incisions, superficial tumor resection, mucosal incisions, and fine dissection. The 810 nm laser is the first choice for delicate procedures.
  3. >30 W: Tissue Vaporization Mode
    Effects: Layer-by-layer vaporization and clearance of target tissue, leaving a smooth wound bed. Applications: Ablation of growths, polyps, warts, cysts, and hyperplastic tissues. The 980 nm laser is preferred for superficial lesions.
  4. >60 W: Tissue Carbonization Mode
    Effects: Tissue dehydration and carbonization, forming a hard carbonized crust. Applications: Sealing massive hemorrhage, treating refractory keratinized lesions, and devitalizing lesion surfaces. Application time must be strictly limited, and it is strictly prohibited for use on normal tissues.
IV. Multi-Departmental Clinical Applications of 810 nm/980 nm Semiconductor Lasers
Relying on their comprehensive capabilities in cutting, vaporization, carbonization, and hemostasis, high-energy 810 nm and 980 nm semiconductor lasers have become routine surgical equipment across multiple departments, with specific wavelengths and power settings selected according to tissue characteristics.
(I) Stomatology (Oral Surgery)
Oral tissues feature thin mucosa, rich vascularity, and confined operating spaces, making this one of the most mature fields for 810 nm and 980 nm laser applications.
  1. Periodontal Surgery: 10–20 W is used to cut diseased epithelium on the inner walls of periodontal pockets, while >30 W vaporizes periodontal granulation tissue. For refractory periodontal bleeding, low-power (5–10 W) coagulation is applied. The 980 nm laser yields better vaporization results for hyperplastic periodontal tissues.
  2. Oral Mucosal Lesions: Polyps, mucoceles, and papillomas are removed layer-by-layer via vaporization at 30 W, resulting in virtually no intraoperative bleeding and mild postoperative edema. For hyperkeratotic mucosal lesions, short-term carbonization (>60 W) can be used for surface devitalization.
  3. Tooth Extraction and Alveolar Surgery: Gingival incisions at 15–25 W replace traditional scalpels. Post-extraction alveolar oozing is managed with low-power coagulation, reducing the need for sutures.
  4. Maxillofacial Minor Tumor Resection: Superficial facial tumors prioritize the 810 nm laser due to its high cutting precision and minimal thermal damage, lowering the risk of postoperative scarring.
(II) Dermatology
Lasers are primarily utilized for vaporization, cutting, and carbonization to treat skin hyperplasia, growths, and superficial lesions, offering non-invasive outcomes and rapid recovery.
  1. Skin Growths: Common warts, flat warts, skin tags, and seborrheic keratoses are routinely vaporized at 30 W using the 980 nm laser, ensuring thorough removal and low recurrence rates. For warts with an extremely thick stratum corneum, brief high-power carbonization of the surface followed by vaporization is recommended.
  2. Pigmented Nevi and Superficial Tumors: Small benign tumors are precisely cut and vaporized at 20–30 W using the 810 nm laser to control the extent of thermal damage and protect surrounding healthy skin.
  3. Scars and Keratin Hyperplasia: Hypertrophic scars and calluses are reshaped via medium-power vaporization, combined with brief carbonization for thickened keratin layers.
(III) Otolaryngology
The fragile mucosa and complex anatomy of the nasal cavity, pharynx, and ear canal make laser surgery ideal for minimally invasive procedures.
  1. Nasal Surgery: Inferior turbinate hypertrophy and nasal polyps are ablated at 30 W using the 980 nm laser to reduce turbinate volume and improve airflow. Intraoperative oozing is managed with 5–15 W coagulation.
  2. Pharyngeal Surgery: Tonsillar hypertrophy, pharyngeal polyps, and epiglottic cysts are treated with 810 nm lasers at 15–30 W for cutting and vaporization, providing clear surgical fields and avoiding traction injuries caused by traditional instruments.
  3. External Auditory Canal Lesions: Granulation tissue and cholesteatoma epithelium are precisely vaporized at medium power, minimizing the risk of tympanic membrane damage.
(IV) General Surgery
These lasers are frequently used for superficial soft tissue surgeries, excision of surface masses, and wound management, replacing traditional scalpels and electrocautery devices.
  1. Surface Tumor Resection: Lipomas, fibromas, and sebaceous cysts are dissected at 15–30 W depending on size. Cyst walls are completely cleared via vaporization, offering superior hemostasis compared to traditional electrocautery.
  2. Surgical Incisions and Debridement: Superficial abscesses are drained using medium-power incisions. Necrotic tissue is cleared via high-power vaporization and carbonization to reduce infection risks.
  3. Anorectal Surgery: Internal/mixed hemorrhoids, anal fissures, and perianal growths are optimally treated with the 810 nm laser. Its excellent coagulation ability allows simultaneous cutting and sealing of hemorrhoidal vessels, significantly reducing postoperative bleeding and pain.
(V) Orthopedics and Sports Medicine
Primarily used for superficial soft tissue release, bone hyperplasia contouring, and periarticular lesion management.
  1. Soft Tissue Release: Tendon adhesions and scar contractures are precisely released at 20–30 W. Localized thermal damage facilitates postoperative functional recovery.
  2. Bone Hyperplasia Contouring: Periarticular osteophytes and superficial bone hyperplasia are smoothed layer-by-layer via vaporization at 40–60 W, avoiding extensive tissue damage caused by traditional bone chisels.
V. Standard Clinical Operating Points, Contraindications, and Safety Protocols
As high-energy surgical lasers, improper control of 810 nm and 980 nm lasers can cause complications such as thermal burns to normal tissues, perforation, and excessive carbonization. Laser energy must remain in constant motion, and the beam must never be stationary on a single spot. Strict adherence to operational workflows and safety guidelines is mandatory.
(I) Preoperative Preparation
  1. Equipment Check: Ensure the laser host, transmission fiber, and surgical probe are intact with no light leakage or fiber breakage. Select the appropriate wavelength and preset power and working modes (primarily CW; pulsed waves may be used for delicate operations).
  2. Patient Assessment: Determine lesion location, tissue thickness, and vascular distribution to formulate a power gradient plan. Exercise caution with patients who have keloid tendencies, coagulation disorders, or acute localized purulent infections.
  3. Protective Measures: Both medical staff and patients must wear wavelength-specific laser protective eyewear to prevent retinal damage from reflected light. Non-treatment areas should be covered with sterile dressings.
(II) Core Intraoperative Operating Points
  1. Stepwise Power Adjustment: Never start at maximum power. Begin with low-power test shots, observe tissue response, and incrementally increase power.
  2. Probe Posture: Maintain the fiber probe perpendicular to the target tissue at a stable distance, moving uniformly. Avoid prolonged stationary irradiation to prevent heat accumulation leading to deep burns or excessive carbonization.
  3. Effect Control: Maintain continuous movement during cutting to ensure seamless incisions. Follow a “small amounts, multiple passes” principle for vaporization. Limit carbonization strictly to diseased tissues and cease output immediately upon achieving the desired effect.
  4. Real-time Observation: Closely monitor wound color and bleeding. Stop the laser immediately if abnormal burns or extensive carbonization occur.
(III) Contraindications
  1. Absolute Contraindications: Direct laser exposure to ocular tissues; lesions adjacent to major blood vessels, trachea, esophagus, or main nerve trunks without effective protection; undifferentiated malignant tumors (blind carbonization/vaporization is prohibited); uncontrolled active massive hemorrhage.
  2. Relative Contraindications: Patients with impaired skin sensation, diabetes complicated by severe peripheral vascular disease, or pregnant women undergoing deep surgeries on the trunk or limbs. Power must be reduced, and the application area minimized.
(IV) Postoperative Care and Equipment Maintenance
  1. Wound Management: Routinely disinfect wounds after cutting or vaporization; superficial wounds can heal naturally. Do not forcibly peel off residual carbonized tissue; allow it to slough off naturally.
  2. Equipment Maintenance: Clean and sterilize fibers and probes post-surgery; avoid impacting the fiber. Calibrate output power regularly to ensure accuracy. Store equipment in a dry, light-proof environment.
VI. Technological Development Trends and Prospects
With the widespread adoption of minimally invasive surgery, 810 nm and 980 nm high-energy semiconductor lasers have become foundational clinical surgical tools. Looking ahead, four major development trends are emerging:
(I) Intelligent and Precise Power Regulation
Traditional devices rely on manual adjustments, which are prone to human error. Future equipment will integrate intelligent temperature control and tissue recognition modules to monitor target tissue temperatures in real time and dynamically adjust output power. During cutting, power remains stable to ensure incision quality; when approaching normal tissue, power automatically decreases to transition into coagulation mode. This hardware-level safeguard reduces complications like thermal injury and excessive carbonization, achieving “intelligent error prevention.”
(II) Dual-Wavelength Integrated Systems
Integrating 810 nm and 980 nm light sources into a single device allows one-click wavelength switching without changing hosts. For complex surgeries combining cutting, vaporization, and hemostasis, clinicians can switch wavelengths in real time based on tissue layers, balancing cutting precision and vaporization efficiency. This multi-purpose capability meets diverse departmental needs and reduces procurement costs.
(III) Miniaturization and Specialization of Fibers and Probes
For narrow-cavity surgeries in otolaryngology, stomatology, and proctology, ultra-thin flexible fibers and angled specialized probes are being developed to enhance accessibility to deep, concealed areas. Customized spot probes tailored for specific departments will further optimize cutting and vaporization outcomes.
(IV) Refinement of Clinical Standardization Systems
Power parameters and operational workflows currently vary across institutions. The industry will progressively develop clinical guidelines for 810 nm/980 nm laser surgeries, standardizing recommended power ranges, exposure times, and protocols by department, disease, and tissue type. Large-scale clinical studies quantifying tissue damage at different power levels will also provide evidence-based data support.
(V) Expansion into Cross-Disciplinary Applications
Beyond conventional surgery, applications are extending into interventional minimally invasive procedures, veterinary surgery, and medical aesthetics. Leveraging high-power vaporization and carbonization, new indications such as minimally invasive ablation of superficial tumors and radical treatment of refractory dermatological lesions are being explored to maximize technological value.
VII. Conclusion
Leveraging unique optical absorption characteristics and controllable photothermal effects, 810 nm and 980 nm near-infrared semiconductor lasers achieve four sequential functions—tissue coagulation, cutting, vaporization, and carbonization—through gradient variations in output power. Distinct from 650 nm low-energy therapeutic lasers, they are indispensable therapeutic tools in clinical minimally invasive surgery. The 810 nm laser focuses on fine cutting and deep hemostasis, while the 980 nm laser excels in superficial vaporization and carbonization. They complement each other and widely used in multiple departments such as dentistry, dermatology, otolaryngology, general surgery, and proctology.
In clinical practice, power parameter settings, exposure duration, and operational techniques are critical determinants of efficacy and safety. Operators must thoroughly understand tissue responses corresponding to different power levels and strictly adhere to protective and operational protocols to mitigate risks of thermal burns and excessive carbonization. Technologically, intelligent regulation, dual-wavelength integration, and specialized accessories represent future mainstream directions. Accompanied by the continuous refinement of clinical standards, 810 nm and 980 nm high-energy semiconductor lasers will play an increasingly vital role in minimally invasive medicine, driving clinical surgeries toward greater precision, enhanced safety, and improved minimal invasiveness.
(This article is for reference only.)