Eye-safety requirements for Nd:YAG laser application in gastroenterology, urology, and neurosurgery

The preconditions relating to radiation safety for application of the Nd:YAG laser in the various fields of open and endoscopic surgery are studied. Potential eye hazards of clinical personnel using a Nd:YAG laser photocoagulator in surgical procedures are investigated and methods of eye protection are discussed. The amount of exposure of the eye to radiation back-scattered from stomach and bladder tissue, as can occur in clinical practice, has been determined for several commercially available rigid cystoscopes and flexible gastroscopes. In addition, the amount of back-scatter from brain and liver tissue has been established under the usual surgical working conditions. The International Electrotechnical Commission (IEC) and the American National Standard Institute (ANSI) provisions relating to laser safety are briefly explained in relation to the use of the Nd:YAG laser. The results of experimental investigations are compared with the maximum permissible exposure (MPE) limiting values as per the IEC and ANSI drafts. The precautions necessary for safe application of the Nd:YAG laser in the various medical spheres are described.