ROCAMED SIRIUS - 6.6 Contraindications for Laser Surgery

51
DGM001519.01 UM Sirius CE/ROTW
Read General laser complications for a list of additional complications
Complications for Gastroenterology Surgery
x Patients may experience gastrointestinal distension or pneumothorax during or after therapy.
x Swallowing may be worsened, rather than immediately improved, following esophageal procedures
due to secondary tissue edema. This potential problem should be explained to the patient prior to the
therapy.
Read General laser complications for a list of additional complications.
Other medical specialties
Read General laser complications earlier in this chapter for further information.
Contraindications for laser surgery
The use of the laser is contraindicated:
x In patients whose general medical condition contraindicates surgical intervention
x When appropriate anaesthesia is contraindicated by patient history or inability to receive anaesthesia.
x Where tissue (especially tumors) is calcified.
x For hemostasis of vessels with diameters over approximately two millimeters.
x Where laser therapy is not considered the treatment of choice.
x In patients who have recently undergone radiotherapy. Such patients may be at greater risk of tissue
perforation or erosion.
x In patients unable to receive endoscopic treatment.
x In patient suffering from bleeding disorders and coagulopathy.
Specific Precautions and Contraindications
Urology:
The laser must not be used with patients with the following conditions:
x Inability to receive endoscopic treatment.
x Intolerance to anaesthesia.
Contraindicated for patients:
x Diagnosed with acute or chronic prostatitis.
x Diagnosed at the time of treatment with acute or chronic urinary tract infection.
x With confirmed or suspected malignancy of the prostate (digital rectal examination, elevated PSA or
abnormal ultrasound of the prostate), unless they are not a candidate for radical prostatectomy or
brachytherapy and present with bladder outlet obstruction.
x Whose general medical condition contraindicates surgical intervention.
x Where appropriate anesthesia is contraindicated by patient history.
x Where tissue is calcified, especially tumors.
x Diagnosed with Prostate Cancer.
x Diagnosed with Acute Urinary Infection (UTI).
x Diagnosed with Severe Urethral Stricture.
KƚŚĞƌĐŽŶƐŝĚĞƌĂƚŝŽŶƐƌĞƋƵŝƌŝŶŐWŚLJƐŝĐŝĂŶƐĐůŝŶŝĐĂůũƵĚŐĞŵĞŶƚ
x Patients with compromised renal function, i.e. serum creatinine level > 1.8 mg/dl or upper urinary tract
obstructive diseases.
x Patients who still wish to have children.
x Patients with an ASA classification of physical status 5.
x Patients with a prostate gland > 120g.