Safe Changing of Biolase Waterlase Tips and Handpieces

[Swpmn]

In the General Erbium section, there were some questions posed regarding changing of tips/handpieces on the Biolase Waterlase erbium.  I asked a Biolase engineer to provide clarification and specific recommendations:

1)  The Waterlase delivery system has an optical conduit for the erbium beam.  There are three additional and separate input lines: air to cool the fiber, water for spray, air for atomization of water spray.

2)  Optical conduit is only completely sealed from water when the tips and handpiece are in place.

3)  When the tip is removed a seal is broken and water could get back into the handpiece head and onto the mirror.  It is recommended that tips only be changed with the Waterlase in the READY mode so that the fiber cooling air line blows any water out of the handpiece head and off the mirror.

4)  When the handpiece is removed another seal is broken.  It it is therefore recommended that the handpieces be dried out or purged of water prior to removal.  Easiest way to purge water from the handpiece:

a)  Waterlase is in STANDBY mode
b)  Set Waterlase to pre-set #1(90% air, 75% water)
c)  Turn water bottle toggle switch to OFF
d)  Scroll the air and water settings to ON mode
e)  Press READY button and water will be pushed out of the handpiece
f)  Press STANDBY button and then turn off the laser

Dried handpiece may now be autoclaved with proximal and distal tips in place.  If you don’t disconnect the handpiece there is no need to purge water from the system.  Always store the laser with tip removed and distal sealing cap in place on the handpiece.

5)  In high humidity areas or when there has been a rapid change in temperature, it may be possible for condensation to occur within the handpiece head and on the mirror.  In such cases, it is recommended to remove the distal sealing cap from the handpiece and then set the Waterlase to the READY mode for 30 seconds prior to attaching the tip for use.  This will blow out any water which may have condensed on the mirror or in the handpiece head.

Al

[Swpmn]

QUOTE

4)  When the handpiece is removed another seal is broken.  It it is therefore recommended that the handpieces be dried out or purged of water prior to removal.  Easiest way to purge water from the handpiece:

a)  Waterlase is in STANDBY mode
b)  Set Waterlase to pre-set #1(90% air, 75% water)
c)  Turn water bottle toggle switch to OFF
d)  Scroll the air and water settings to ON mode
e)  Press READY button and water will be pushed out of the handpiece
f)  Press STANDBY button and then turn off the laser

In the e) section of this recommended protocol I should have posted a time interval for the purge process. Dr. Mark Colonna, who has a great deal of knowledge on maintenance of the Waterlase, advised that the purge should be performed for 90 seconds.

If users watch the clear, blue colored water tubing near the proximal end of the erbium trunk fiber connection port, you can observe water bubbles being pushed back into the water irrigant bottle. When no more water bubbles are observed pushing back through the blue line, one may be assured that the handpiece has been properly purged and dried out.

Thanks to Dr. Colonna for improving the recommended protocol.

Al

[dilbert]

A useful post regarding checking the moisture content of your compressed air from DT:

>>>>>>>>>>>>>
1) Oil-Less compressor will certainly help but its not the whole story. Compressed air has a higher moisture content and is usually warm, as it navigates its way to the chair through cold pipes it condenses and this water can find its way into the laser.
Most important are filters which can remove Oil, Air and Odours and are regularly checked to drain the fluids from them, an unchecked filter is useless.
Also check the O’rings on the coupling for the handpiece, I have had a couple of UK docs who have chunks missing out of the O’rings causing the water to leak. Twist the handpiece on and off the coupling this helps.
2) Remove a highspeed, turn off the water spray and step on the pedal, blow the air onto a mirror and it should stay perfectly clear, any water or oil and there is a problem.
3)Purging is good.
I have an Interactive Training CD for the Waterlase, ask your rep to see it.

Hope this helps

Tazzy

<<<<<<<<<<<<<<<<<<<<<

added >>>> <<<<< brackets 6/23/04 — Didn't intend to give the impression that I am Tazzy.

Dilbert

(Edited by dilbert at 11:26 am on June 23, 2004)

[Swpmn]

Tazzy:

Personally I don’t believe there is anything to this Water/Oil in Compressed Airline Theory. Although I do think there was a design flaw in the original Waterlase trunk fiber, my observations indicate that the system is sealed from water contamination in the second and third generation trunk fibers(except when tips and handpieces are changed). As long as water purging procedures prior to handpiece changes and air ON during tip changes are followed, I believe there are minimal risks to the trunk fiber. Clearly Biolase has improved the trunk fiber as I have observed a decrease in reports of trunk fiber failure while there has been a significant increase in the number of users.

We appreciate your input and recommendations.

Al

[Author]

Posts