Investigation of operator inhalation hazards from the aerosol created by neodymium:yttrium aluminum garnet laser surgery.

The Neodymium:Yttrium Aluminum Garnet (Nd:YAG) laser is being used by an increasing number of surgeons and physicians throughout the country as a photo-coagulator and as a tool to remove tumors, especially in areas where fiber optics can be utilized, such as in endoscopy and bronchoscopy. Although numerous studies have examined the aerosol generated during CO2 laser surgery, no study has examined the aerosol generated from a continuous wave Nd:YAG laser. This study examined four separate surgical procedures: a canine partial splenectomy, the vaporization of human squamous cell carcinoma, the vaporization of canine strap muscle, and the vaporization of beef liver. The aerosol created during these procedures was collected on a number of sampling devices. The analytical methods used in analyzing the aerosol included HPLC GC/MS, and Ames tests. The results of these analyses indicated that it is unlikely the PAHs or nitrosamines are formed during laser surgery. The Ames tests used in this study did not show the aerosol collected during the vaporization of beef liver to mutagenic; however, the quantity of aerosol added to the plates was very small. The GC/MS analysis of the canine partial splenectomy detected the formation of a nitrogenous aromatic; however, further identification was not possible. Since some nitrogenous aromatics are believed to be potentially carcinogenic in man further research in needed. These data support the belief that laser aerosol should be locally exhausted and kept to a minimum.