Introduction
Materials and Methods
Choice of Laser Machine
Author | Year | Study overview | Safety lessons |
---|---|---|---|
Laser type | |||
Ulvik et al. [2] | 2022 | Randomised clinical trial of Ho:YAG vs. TFL | • Significantly fewer intra-operative bleeding events impairing view associated with TFL compared to H.YAG (5% vs. 22%, p = 0.014) |
Sierra et al. [13] | 2022 | Thermal injury associated with Ho:YAG vs. TFL (in vitro model) | • Higher risk of damage with higher power settings and less experienced surgeons |
Laser fibre choice, handling and technique | |||
Paterson et al. [27] | 2019 | Survey of urologists in Endourological Society | • 19% of respondents had witnessed some kind of laser adverse event • Only 40% routinely wore laser protection eyewear • 76% had received formal laser training • 64% had formal laser safety policy at their hospital |
Althunayan et al. [9] | 2014 | Review of US Manufacturer and User Facility Device Experience (MAUDE) database | • No eye injuries or deaths associated with Ho:YAG only skin burns to staff • Most adverse events due to fibre breakage |
Tsaturyan et al. [24] | 2022 | Thermal effects of prolonged laser activation (in vitro model) | • Continuous activation at 12 Watts at 10 ml/min outflow caused threshold (43 °C) to be exceeded after only 1 min |
Æsøy et al. [14•] | 2022 | Thermal effects of varying fibre size | • Larger fibres result in greater temperature changes |
Ocular injury | |||
Villa et al. [29] | 2016 | Ocular injuries in ex vivo pig model with Ho:YAG | • Corneal damage occurs at 0–5 cm |
Panthier et al. [31••] | 2022 | Ocular injuries in ex vivo pig model with TFL | • Corneal damage occurs at 0–5 cm |