Technical Problems of First Generation Arthroscopic Laser Surgery

Abstract

The enthusiasm of laser arthroscopy is accompanied by technical problems that should be viewed by all arthroscopists. First generation 10.6 μm CO₂ lasers have been the most cumbersome systems. The dual gas and liquid mediums they require have been burdensome (Brillhart 1991b, 1992). The large waveguides and associated defocused laser beams used with the first generation 10.6 μm CO₂ laser systems made them more prone to inadvertent tissue damage when compared to the newer, smaller waveguides. The delivery systems for the 1.06 μm neodymium:YAG and first generation 2,1 μm holmium:YAG lasers were more user friendly but were associated with probe failures and tip breakages (Brillhart 1991c, d, 1992). The angles of the probes and the probe tip designs were not suited ideally for all arthroscopic procedures. Arthroscopists must be aware that some of these problems have yet to be eliminated. Surgeons should familiarize themselves with associated potential technical problems and be prepared to deal with them. The latest generation laser systems should be considered for use.