The Structure of a Fiber Lasers for Medical Purposes: a Scoping Review: A Scoping Review

Background. Fiber lasers are promising for use in biology and medicine due to their compactness, combining the functions of a laser and a light guide, and the possibility of creating multi-channel laser systems. They can be successfully used in laser microsurgery, therapy and diagnostics, in particular in genetic engineering, cytometry, in situ blood irradiation, simultaneous reflexotherapy, etc. In recent years, there has been a surge of interest in Thulium Fiber Laser (TFL), which corresponds to the parameters of world manufacturers. Purpose. The main purpose of this review is to study how laser methods are used in medicine. Various fiber lasers for various fields of medicine are described. This is the first review in which an attempt has been made to cover the field of application in medicine quite widely - from laser scalpels-coagulators (which have found application in cosmetology, gynecology, when stopping severe bleeding) to diagnostic methods. Materials and methods. To explore this area, we conducted a scoping review of scientific articles from the Scopus database. A total of 313 studies were selected, the number of which was reduced to 84. Studies published in English from 2020 to 2022 were reviewed. Results. We have identified various methods of constructing, collecting and analyzing information and evaluated them in terms of efficiency and quality. Several articles contained information about the technology of fiber lasers in medicine. Conclusion. At present, the development of fiber lasers is at the second stage of development and consists in the simultaneous use of intelligent photon cabins and photon engines. When lasers with single-beam outputs appear, the restriction is assumed to be practically diffractive, the range is several hundred kilowatts, which will be achieved by combining a number of intelligent devices with maximized stability and power efficiency. This review also revealed the weak side of fiber lasers, the expert community considers the following factors: 1) high probability of nonlinear effects, which, in turn, is explained by the increased radiation density in the medium (fiber); 2) a relatively low value of the output energy in the pulse, which is associated with a small amount of active substance; 3) there is limited data on the use and clinical outcomes of TFL. Research focused on identifying the most appropriate conditions and providing initial safety data.