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DGM001519.01 UM Sirius CE/ROTW
Thoracic Surgery:
x Contraindicated for patients with lung emphysema (risk of prolonged air leakages upon surgery)
x Contraindicated for patients with pulmonary hilar tumor close to large vessels.
Read General contraindications for laser surgery earlier in this chapter for further information.
ENT:
The thulium wavelength should not be used in patients with any of the following conditions:
x Inappropriate candidates for endoscopic treatment
x Endonasal malignant neoplasm
x The use of thulium laser is not recommended for stapedotomy/stapedectomy.
Read General contraindications for laser surgery earlier in this chapter for further information.
Lithotripsy:
x Contraindicated in case of inability to receive endoscopic treatment and intolerance to anaesthesia.
x Contraindicated in case of difficult access to the stone.
x The laser should be used with an optical fiber delivery system in direct view and in direct contact or
close proximity with the target stone.
x Be aware of edematous folds of epithelium that may lie between the optical fiber and the stone.
x Baskets, guide wires, and other endoscopic accessories may be damaged by direct contact with the
laser treatment beam.
x The use of irrigation is recommended throughout the lithotripsy procedure to absorb any produced
heat, to carry stone fragments out of the urinary system, and to enhance direct visualization. The rate
of irrigation should be carefully adjusted to avoid flux of calculi into the kidney.
x Unexpected tissue damage may occur due to excessive power application. Use of excessive power may
result in inadvertent perforation or damage of tissue structures.
Read General contraindications for laser surgery earlier in this chapter for further information.
General Surgery:
Contraindicated for patients with any of the following conditions:
x Septic peritonitis
x Intestinal obstruction
x Septic shock
x Resection or excision of large, highly vascularized organs (e.g. spleen, liver)
Read General contraindications for laser surgery earlier in this chapter for further information.
Other medical specialties:
x No specific information, refer to General Contraindications and precautions.
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