Independent of one’s laser technique or the type of bronchoscope used, certain basic principles must be adhered to during laser resection. This does not mean that laser resection is just as safe or effective using the flexible bronchoscope. In case of endobronchial obstruction, we believe that the rigid bronchoscope guarantees better results faster than the flexible bronchoscope, while securing the airway in case of aspiration or bleeding.
Laser resection consists of the following steps : coagulation, excision, hemostasis, and aspiration of secretions, blood, and/or debris. Resection can begin once the fiber is in place. The laser should never be aimed directly at the airway wall. Ideally, it should be fired parallel to the airway’s axis, though this may not always be possible.