Brodman M, Port M, Friedman F, Sperling R, Dottino P, Thomas A G
Mount Sinai Hospital, New York, New York.
Obstet Gynecol. 1993 Apr;81(4):607-9.
To determine the extent of laser-induced morbidity away from the operative site during the preceptor phase of laser credentialing in our institution.
All laser surgeries performed from June 1, 1990 through May 31, 1991 and preceptored by one of the authors (MB) were included in the study. All of the surgeries were performed by a resident or attending physician seeking laser privileges in our institution. During that time, 141 such cases were performed.
In 13 of 141 cases (9%), there were injuries unrelated to the surgical procedure itself to either the patient or operating personnel. There were nine accidents associated with laser use during 42 laparotomy procedures (21%) and four accidents at the time of 44 vulvar surgeries (9%). There were no accidents during laparoscopic or colposcopic surgery of the vagina or cervix.
Despite extensive training requirements before use of the CO2 laser, accidents did occur. Operating room safety requirements should be a high priority to minimize morbidity. We report our experience with intraoperative morbidity caused by surgeons' errors and present recommendations to limit further complications.
确定在我们机构进行激光资格认证带教阶段，远离手术部位的激光诱发并发症的程度。
本研究纳入了1990年6月1日至1991年5月31日期间由作者之一（MB）带教的所有激光手术。所有手术均由在我们机构寻求激光手术权限的住院医师或主治医师进行。在此期间，共进行了141例此类手术。
在141例病例中的13例（9%）中，患者或手术人员出现了与手术操作本身无关的损伤。在42例剖腹手术中有9起与激光使用相关的事故（21%），在44例外阴手术时有4起事故（9%）。阴道或宫颈的腹腔镜或阴道镜手术期间未发生事故。
尽管在使用二氧化碳激光前有广泛的培训要求，但事故仍有发生。手术室安全要求应列为高度优先事项，以尽量减少并发症。我们报告了外科医生错误导致的术中并发症的经验，并提出了限制进一步并发症的建议。
