User's Manual

Lumenis
®
Pulse
TM
50H / 100H Laser Systems Complications
UM-20006520DE, Rev. A Page 25
until familiar with the instrument’s capabilities. Use extreme caution
until the biological interaction between the laser energy and tissue is
thoroughly understood.
• Due to interaction between flammable gases in the operating field and
the laser energy a flash fire may occur. Therefore, during laser
procedures, measures to minimize this potential hazard should be
practiced (e.g. avoid administration of inhaled general anesthetics;
reduce oxygen levels during mechanical ventilation, use of laser
resistance endotracheal tubes). The flammability of methane gas must
also be considered when treating in or near the perianal area.
• The laser system should be used only on tissues that are fully
observable. Do not use the laser system if the desired target is not
visible. All available measures to visualize the target tissue (e.g.
copious irrigation, hemostasis) should be taken.
• When using endoscopic equipment confirm that the tip of the optical
fiber extends at least 12 mm beyond the end of the scope during laser
treatment. Activating the laser system when the tip of the optical fiber is
within the scope can result in penetration of holmium laser energy
through the scope and destruction of the scope.
• Use of the laser system on anatomical structures in proximity to known
critical structures, such as large arteries, veins, bowel, ureter, bladder,
nerves, etc., should be performed carefully to avoid inadvertent or
unintended damage of such structures. If applicable, maintain irrigation
in the treatment area to reduce heat accumulation.
• Use caution when treating patients who have recently undergone
radiotherapy. Such patients may be at greater risk of tissue perforation
or erosion.
• Highly vascularized anatomical structures should be approached with
caution, taking into account the limited coagulative properties of the
laser system. Electrocautery and/or suture (ligature) should be easily
accessible in the event that a bleeding vessel is larger than possible to
control with the laser system. The risk of bleeding may be higher in
patients taking anticoagulants/ platelet aggregates.
• Baskets, guide wires, and other surgical accessories may be damaged
by direct contact with the laser treatment beam.
Complications
The following is a list of general complications that are related to surgery
and within this context, laser surgery. The potential complications
encountered in endoscopic laser surgery are the same as those normally