Complications in Equine Surgery. Группа авторов

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Complications in Equine Surgery - Группа авторов


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cleaved and stripped for a new procedure. The fiber tips should be clear and the aiming beam should go out the end of the fiber. Frosted or charred tips cause light to diffuse out of the sides or not at all. Worn‐out tips are inefficient and brittle.

Photos depict (a) Preoperative laser fiber inspection in a darkened room with the aimed beam turned on showing a fiber defect that will certainly burn out and damage the endoscope. (b) Damaged quartz fibers that burn out in the endoscopic channel severely damage the endoscope

      Source: Kenneth E. Sullins.

      Plastic coated gas cooled quartz fibers should be inspected in the same manner as bare fibers and gas flow through the tip should be verified. Occluded gas flow results in immediate burn out of the quartz fiber. If a sapphire tip is to be added to the gas cooled fiber, the threads must be inspected so the energy goes out through the tip and not the side. If, during lasing, the metal tip “blows” or “flares up,” it is probably ruined and the metal will have become melted or deformed. The endoscope should be removed from the patient with the fiber in place. If damaged, the tip should be cut off before bringing the fiber back through the scope or the interior of the biopsy channel can be damaged.

      Fibers that fit too tightly in the biopsy channel are at risk of overheating and burning out and damaging the interior of the endoscope. In general, 600–800‐micron fibers fit well. Passing bare fibers through a Teflon tubing liner facilitates passage and protects the tip of the endoscope. Gas‐ cooled fibers should pass through with no trouble.

      Surgical lasers broaden and deepen surgical possibilities to the advantage of patients and owners and new applications continue to appear. As long as the surgeon understands laser physics and tissue interaction and exercises a few straightforward precautions, the results will be pleasing for all involved.

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