Initially, the medical applications for lasers were as thermal devices for cutting and vaporising tissue in a precise way. In the 1980s the combination with optical fibres enabled lasers to reach obstructions in the wind pipe, lungs and food pipe (trachea, bronchus and oesophagus) via the mouth, without the need for traditional invasive surgery. These lasers could also be used in conventional invasive procedures.
A UK registered charity, was created in 1984 to purchase a thermal (Nd YAG) laser for Professor Moghissi to undertake treatment and research into the use of lasers in thoracic surgery at the NHS hospital where he was based; he became the first surgeon in Europe to use laser intra-operatively to treat thoracic disease.
In 1989 Yorkshire Cancer Research provided Prof. Moghissi with a Dye laser to undertake the first clinical trial in Photo Dynamic Therapy (PDT) in the UK for cancers of the bronchus and oesophagus; PDT uses a gentler laser light to activate a photosensitive drug which is absorbed by cancerous cells. .
This research, in co-operation with colleagues in Japan and the US, was instrumental in leading to clinical licensing in these areas in the UK and Europe, as well as the United States, and ultimately to The National Institute for Health and Clinical Excellence (NICE) approval in England for PDT funding within the NHS.
By the time Professor Moghissi retired from the Health Service, he had undertaken many research projects and had several hundreds of published papers to his name. His research and development continued from an independent base alongside the NHS Goole & District Hospital.
In 1997 this location was used to establish The Yorkshire Laser Centre (YLC) - an independent company Limited by Guarantee (reg no:3547276) alongside the NHS. The modern hospital offers excellent facilities in a central location close to the motorway network, railway stations and airports.
An initial priority was to expand the availability of Photo Dynamic Therapy treatment through ongoing development, research and training. This was also disseminated through the medical community in the UK, Europe and around the world with the publication of numerous professional articles, research papers and conference presentations. The Centre stimulated and supported the development of laser treatment and research at other hospitals and within other medical disciplines such as dermatology, gynecology, urology, orthopaedics, colo-rectal, oral, maxillo-facial and general surgery.
As the Centre has developed, more Honorary Consultants have been appointed to treat patients and undertake clinical research at the NHS facilities at Goole & District Hospital. In addition, a Mobile Unit was launched to provide laser equipment and expertise to other hospitals in the region to enable patients to be treated locally.
The Centre has also been approved to provide Medical Laser Training by the BMLA, EPPM and equipment manufacturers, to help disseminate the skills required for effective medical laser treatment.
Another aspect of the use of lasers is in Photo Detection - the early detection of pre-cancerous cells. This was the focus of a specific piece of research called 'Project First Light'. This used a specific wavelength of laser light to create a fluorescence effect which highlighted suspicious tissue which was invisible under standard white light illumination. The research used the technique to identify target areas for treatment for patients undergoing PDT, for subsequent follow-up examination and in the screening of high risk groups that had a family history, smoked, or had already had cancer.
The Centre's growing national and international role and reputation has resulted in it also operating as the UK Medical Laser Centre (UKMLC); this reflects its emergence as an accredited UK training centre for PDT; plus its leadership within the British Medical Laser Association (BMLA) and the European Platform for Photodynamic Medicine (EPPM). In addition the Centre has entered into a partnership relationship with the NHS at Goole & District Hospital to facilitate the expansion of treatment and research across a growing range of disciplines.
Work is also undertaken in association with the Universities of Hull, Leeds and York and in hospitals in Hull, Grimsby, Scunthorpe and Leeds, as well as Dundee and Cardiff.
In summary, key milestones for Professor Moghissi and YLC include:
First use of YAG laser in the UK and Europe in chest surgery.
First use of Photodynamic Therapy (PDT) for endobronchial cancer.
First combined use of YAG lasers and photodynamic therapy lasers in minimal access surgery.
Extension of laser applications to other specialties, including urology, orthopaedics, colo-rectal, oral, maxillo-facial, general surgery and gynaecology.
Appointed training centre for photodynamic therapy.
Development of a Mobile Unit to provide equipment and expertise to deliver treatment in external hospital locations.
Trials of Photo Detection techniques used in conjunction with PDT and for screening of high risk groups