Adjusting The Energy Per Pulse; Surgical Complications And Risks - COOK Medical H-30 User Manual

Soft Tissue
• Use the Short pulse width if you want to minimize coagulation or create a large, thick
cut/vaporization area.
• Use the Long pulse width if you want to increase coagulation and decrease bleeding.
Notes
• Most soft tissue cases will benefit from using the Long pulse width mode.
• If conditions have changed, such as a piece of an impacted stone breaks off or the
soft tissue is bleeding more than expected, the pulse width mode can be easily
switched with the tap of a toggle button.

Adjusting the Energy per Pulse

Adjust the energy per pulse to match the desired clinical effect.
Lithotripsy
• Lower pulse energy will cause the particulate size to be smaller (dusting the stone)
and cause less retropulsion.
• Higher energy will create larger fragments (busting or drilling the stone) but will also
cause more retropulsion.

Surgical Complications and Risks

The same complications and risks that exist for conventional or traditional surgery exist
for laser surgery such as but not limited to:
• Pain—Short lived pain may occur immediately following endoscopic laser surgery and
may persist for as long as 48 hours.
• Fever and Leukocytosis—Immediately following endoscopic laser surgery, the patient
may experience fever and leukocytosis, which are commonly associated with tissue
degradation. These conditions are generally resolved without treatment. Tissue
cultures are indicated to exclude the possibility of infection.
• Bleeding—Patients may experience bleeding at the surgical site or from erosion of a
tumor during or after laser surgery. Post treatment blood studies, such as hematocrit
levels may be necessary.
• Sepsis—Lase ablated tissue may become infected after surgery. If a question of sepsis
exists, a culture should be taken and other appropriate evaluations made.
• Perforation—Perforation can occur as a result of endoscopic or cystoscopic
procedures. To clinically diagnose perforation, patients must be monitored
postoperatively through physicial signs, hematocrit and radiography.
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Chapter 4
Indications & Instructions for Use
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