A ten year experience treating cervical intraepithelial neoplasia with the CO2 laser

Article Abstract:

Treatment of cervical cancer which has not invaded other nearby organs greatly reduces the risk of the cancer progressing to the invasive stage, while at the same time maintaining the integrity of the cervix. A variety of treatment techniques have been used over the years. The carbon dioxide laser vaporization (a type of laser using narrowly focused, amplified light beams for the manipulation of tissue in surgery) was previously considered less advantageous than other methods, but has recently demonstrated improved therapeutic results. Over a ten-year period, 3070 women diagnosed with cervical intraepithelial neoplasia, cancer not yet invading surrounding tissues, were treated with a laser vaporization "buttoning" technique which had a 93.8 percent cure rate. Patients having excisional conization, involving the removal of diseased tissue by a cone-shaped laser excision, had a 97 percent cure rate. A common complication associated with the laser method is bleeding during and after surgery. Only 1.34 percent of bleeding patients needed suturing. Cervical stenosis (closing of the cervical canal), incompetent cervix (premature opening of the cervical canal before pregnancy delivery), and pelvic infections were relatively rare. Treatment of non-invasive cervical cancer using the carbon dioxide laser has proven to be a highly effective method.

Care and treatment, Usage, Women, Diseases, Hyperplasia

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Death caused by air embolism associated with neodymium:yttrium-aluminum-garnet laser surgery and artificial sapphire tips

Article Abstract:

Neodymium:yttrium-aluminum garnet (Nd:YAG) laser is a type of laser light beam used to manipulate tissues during surgery. The Nd:Yag laser can be affixed with a sapphire tip which is heated for contact surgery. The tip requires a continuous cooling to prevent the tips from burning up. Cooling is provided by a flow of air, nitrogen, carbon dioxide and salt solution, delivered by fibers to the tip. A 40-year-old woman having Nd:YAG laser surgery to correct abnormal bleeding in the uterus had a cardiac arrest during the procedure. Air was removed from the chamber of the heart and the patient subsequently died. Another patient, a 35-year-old having laser surgery for irregular bleeding in the uterus and painful menstruation, also had cardiac arrest. A large amount of air was removed from the jugular vein and death followed. Physicians are alerted that the use of the sapphire tips can cause air emboli, blockages of blood vessels caused by the presence of air bubbles, which can cause cardiac arrest and ultimately death. It is recommended that sapphire tips not be used for surgery of the uterus or in any areas of the body having a large blood supply.

Causes of, Physiological aspects, Air embolism, Gas embolism

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The effects of loop excision of the transformation zone on cervical length: implications for pregnancy

Article Abstract:

When doctors surgically remove part of the cervix to treat cervical diseases, the cervix is initially shorter but eventually grows back to its original length. This is important because a short cervix may be a risk factor for premature birth.

Measurement, Surgery, Cervix uteri

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