Tissue and Vessel Perforation

Misdirected laser energy may perforate a viscus^{[31] [32] [33] [34]} or a large blood vessel (vessels >5 mm are not coagulable by laser). Laser-induced pneumothorax has been reported after a laryngeal procedure.^[35] With an Nd:YAG system, the depth of damage is impossible to assess accurately or immediately, and perforation and bleeding may not occur until edema and necrosis have become maximal several days postoperatively.