Potential Hazards of Arthroscopic Laser Surgery

  • David H. Sliney

Abstract

With the increasing variety of laser wavelengths being employed for arthroscopy, laser safety issues become more complex and more important to address prior to surgery (Sliney and Trokel, 1992). Laser surgeons must be concerned with protecting the patient and the operating room staff as well as themselves. Patient safety is ensured by limiting needless tissue exposure, by avoiding fire, and by protecting the eyes. Safety of the laser surgeon and assistants requires concern for both system safety design and methods to limit potentially hazardous reflections and optical fiber breakage. Environmental hazards from the smoke produced by vaporizing tissue must be minimized by local exhaust ventilation or fume extractors. The pathogenicity and chemical toxicity of vaporized tissue has been the subject of a number of investigations. Safety standards for medical laser applications have been issued that consider all of these potential hazards and their control measures (Sliney and Wolbarsht, 1980; IRPA, 1985; ANSI, 1988, 1993; Sliney and Trokel, 1992; ACGIH, 1993; IEC, 1993).

Keywords

Argon Fluoride Retina Carbon Monoxide Sponge 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. ACGIH (1993) TLV’s threshold limit values and biological exposure indices for 1990–1991. American Conference of Governmental Industrial Hygienists, Cincinnati, OHGoogle Scholar
  2. ANSI (1988) Safe use of lasers in health care facilities. Standard Z-l36.3–1988. American National Standards Institute, Laser Institute of America, Orlando, FLGoogle Scholar
  3. ANSI (1993) Safe use of lasers. Standard Z-136.1–1993, American National Standards Institute, Laser Institute of America, Orlando, FLGoogle Scholar
  4. Baggish MS, Poiesz BJ, Joret D, Williamson P, Refai A (1991) Presence of human immunodeficiency virus DNA in laser smoke. Laser Surg Med vol. 11, pp. 197–203CrossRefGoogle Scholar
  5. Brillhart AT (1991) Arthroscopic laser surgery. Am J Arthroscopy 1:5–12Google Scholar
  6. Brillhart AT (1992) Technical problems of laser arthroscopy. Abstracts Arthroscopy: The Journal of Arthroscopic and Related Surgery vol. 8, no. 3, pp. 403–4Google Scholar
  7. Garden JM, O’Banion MK, Shelnitz LS, Pinski KS, Bakus AD, Reichman ME, Sundberg JP (1988) Papillomavirus in the vapor of carbon dioxide laser-treated verrucae. JAMA vol. 259, pp. 1199–1202PubMedCrossRefGoogle Scholar
  8. Hirsch DR, Booth DG, Schocket S, Sliney DH (1992) Recovery from pulsed-dye laser retinal injury. Arch Ophthalmol, 110:1688PubMedGoogle Scholar
  9. IEC, International Electrotechnical Commission (1993) Radiation safety of laser products. Equipment Classification and User’s Guide, Document WS 825–1, IEC, GenevaGoogle Scholar
  10. IRPA, International Non-Ionizing Radiation Committee (1985) Guidelines for limits of human exposure to laser radiation. Health Physics vol. 49, no. 5, pp. 341–359Google Scholar
  11. Sliney DH, Wolbarsht ML (1980) Safety with lasers and other optical sources. Plenum Publishing Corp, New YorkGoogle Scholar
  12. Sliney DH, Mainster MA (1987) Potential laser hazards to the clinician during photocoagulation. Amer J Ophthalmol vol. 103, pp. 758–760Google Scholar
  13. Sliney DH, Trokel SL (1992) Medical lasers and their safe use. Springer-Verlag, New YorkGoogle Scholar
  14. Wood RL, Sliney DH, Basye RA (1992) Laser reflections from surgical instruments. Lasers Surg Med, 12:675–678PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1995

Authors and Affiliations

  • David H. Sliney

There are no affiliations available

Personalised recommendations