Laser Surgery Pioneer Isaac Kaplan Dies

Professor Isaac Kaplan, a pioneer in the creation of the first carbon dioxide laser for general surgery and founder of the International Society for Laser Surgery and Medicine, has died. He was 93.

Kaplan was professor emeritus of surgery and past incumbent chair of plastic surgery at Tel Aviv University. He established and headed the Department of Plastic and Reconstructive and Maxillofacial Surgery at Beilinson Hospital (now part of Rabin Medical Center). Haaretz newspaper in Israel reported on his death on Aug. 24.

Before Kaplan, a native of South Africa, turned 20, "he set out for Civitavecchia in Italy, where he learned seamanship on the ship Sarah A at the school established by Jeremiah Halpern for the smuggling of illegal immigrants into Palestine," Kaplan's obituary in Haaretz said. "But his voyage with Halpern ended in a navigational error and a mutiny by the crew, at the end of which Kaplan was locked up at gunpoint."

Kaplan volunteered for the South African army during World War II and became an interpreter in the communications corps because of his fluency in Italian.

As a demobilized soldier, he was accepted to medical school at Witwatersrand University in Johannesburg, but cut short his fourth year of studies in March 1948 to assist in the escape of a group of prestate underground members whom the British had deported to Kenya, Haaretz said.

In 1952, Kaplan immigrated to Israel and was hired by Rambam Medical Center in Haifa. In 1954, he completed his residency in plastic surgery at Hadassah University Hospital and then trained in England with Sir Harold Gillies, the father of British plastic surgery.

In 1967, according to the obituary, he founded the first burn unit in Israel. A year later, he was sent to Saigon, in the midst of the Vietnam War, to establish a large hospital there. He subsequently instructed more than 600 surgeons from around the world on the use of the CO₂ laser in various surgeries.

In 1972, with engineering help from his partner, Uzi Sharon, Kaplan developed the Sharplan Laser, an instrument with versatility and precision previously unavailable in laser technology.

That year, "we embarked on a twofold project designed to investigate the application of the CO₂ laser in surgery as a whole, while at the same time attempting to develop an apparatus which would be human-engineered and designed specially for clinical surgery, bearing in mind the physical conditions and requirements of the average operating room and the idiosyncrasies of the average surgeon," Kaplan said in remarks at the beginning of Lasers in Surgery and Dentistry by the European Medical Laser Association (EMLA).

"The important thing," said Kaplan in a 1988 profile in Laser Medicine and Surgery News and Advances, "was to get the beam over the operating table and into the hand of the surgeon in such a way as to enable him to operate with it, almost like a pencil. You needed the laser, a power pack around the laser, and an articulated arm, with mirrors. These features were necessary in order to bring across the beam, which was maneuverable. The apparatus ended in a handpiece, which was sterilizable, easy to handle and small enough to handle properly."

When it was developed in the 1960s, Kapan said, the CO₂ laser was without application. His goal was to research the application of the new "miracle technology" while developing an apparatus that could put the application to work in general surgery.

"Lasers of various wavelengths, both gas and solid state, became available subsequently, but it was the CO₂ laser produced by [Kumar] Patel in the late '60s that showed promise of being applicable to surgery due to the fact that its beam was shown to be absorbed by water," Kaplan wrote in his Lasers in Surgery and Dentistry remarks. "Since the body tissue comprises ... 75-90% water, it follows that, if the CO₂ laser beam is focused on the body tissue, it will cause a vaporization of the tissue at the focal point, while at the same time, due to the release of thermal energy, the small blood vessels and lymphatics will be sealed.

"When I first started to investigate the application of CO₂ laser in surgery, I promised myself that if I [came] to the conclusion that this modality did not have any advantages over others, I would say so, for the sake of intellectually honesty. Fortunately, this has not been necessary since, in my considered opinion, the CO₂ laser has undoubtedly proved its value as a surgical tool and will remain the laser of choice for surgery."

Kaplan founded the International Society for Laser Surgery and Medicine (ISLSM) in 1975 and served as its president until 1979.

The first meeting of the international symposium of laser surgery, in Tel Aviv in 1975, was attended by "65 people. That's all we had working with lasers at the time," Kaplan said in a 2009 presentation on the history of the society. That meeting gave rise to the foundation of the ISLSM, and by the fourth biannual meeting in Tokyo in 1981, "there were over 1000 participants from all over the world, and it gave us an indication of how lasers in surgery and medicine had developed in that short period."

That also inspired the formation of numerous regional and national societies throughout the world, "with the result that many other lasers, each with its specific application, have been introduced into the medical field," Kaplan wrote in the EMLA publication.

Kaplan also founded the Israeli Society of Laser Surgery and Medicine and was its president until 1995. In 2006, he was named honorary president of the International Association for Phototherapy.

He was the recipient of various international awards, published more than 200 professional articles, wrote two books on plastic surgery and four on laser surgery, and contributed several chapters in other books on lasers in medicine and surgery. He was an honorary member of 27 international societies of laser surgery, medicine and phototherapy.

Kaplan also enjoyed writing poetry in rhyming couplets that often displayed a healthy sense of humor. His work includes pieces on topics such as "CO₂ Laser Circumcision" and "Reincarnation."

Read Kaplan's complete obituary here. To read his poetry, visit: http://isaackaplanpoems.wordpress.com/