Laser and Plasma-based Technologies for Precision Tumor Ablation: A Narrative Review

Abstract

The pursuit of precision in oncologic surgery remains a critical challenge, as conventional resection techniques often face limitations in achieving tumour-free margins while minimising collateral tissue damage. In recent years, energy-based surgical modalities such as laser and plasma technologies have emerged as promising tools to enhance oncologic resection and tumour ablation. Laser surgery, including CO₂, Nd:YAG, diode, and Er:YAG systems, offers precise tissue vaporisation, improved hemostasis, and the ability to perform minimally invasive resections in various cancer types, particularly in head and neck, thoracic, and hepatobiliary oncology. Plasma-based modalities, notably argon plasma coagulation (APC) and cold atmospheric plasma (CAP), have demonstrated unique advantages. APC is widely used for intraoperative hemostasis and tumour debulking in gastrointestinal and thoracic surgery, while CAP has shown experimental efficacy in inducing apoptosis, enhancing wound healing, and eliminating microscopic residual tumour cells. This review summarises the fundamental principles, clinical applications, advantages, and limitations of laser and plasma technologies in surgical oncology. A narrative review was conducted by searching PubMed, Scopus, and Web of Science databases for articles published between 2000 and 2024. Search terms included “laser surgery oncology,” “argon plasma coagulation cancer,” “cold atmospheric plasma tumour ablation,” and “energy devices in cancer surgery”. Future research should focus on randomised controlled trials, optimisation of surgical parameters, and integration with fluorescence-guided and robotic-assisted surgery. Laser and plasma-based surgical technologies represent an emerging frontier in oncologic surgery, with the potential to refine tumour ablation, improve oncological safety, and reshape the paradigm of precision cancer treatment.