Lasers

I had a case where the surgeons were using a laser to excise a lesion on the vocal cords. This sort of surgery has fairly unique considerations. We use a special endotracheal tube made of stainless steel to prevent damage from the laser. This is particularly important because laser will ignite oxygen; airway fire is a real risk in these surgeries. Thus, we run as little oxygen as possible to reduce the risk of setting something on fire. Endotracheal tubes have cuffs that are usually inflated with air. But these laser tubes are equipped with two cuffs and we inflate the proximal one with a dye, methylene blue. Thus, if the laser goes through the cords and cuts the proximal cuff, the surgeon will see the dye; hopefully the distal cuff will remain intact. Laser surgeries have their own safety requirements. We all have to wear laser goggles to prevent eye damage and laser plume masks that are safer for any aerosolized tissue. It surprised me to learn about all these laser-specific considerations, and I thought it was interesting enough to make a blog post.

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