Role of Laser Pointer in Budgeting Fluoroscopy-Time and Radiation Exposure

Abstract

Background: Literature on radiation exposure with use of the mini C-arm and value of having built-in laser guidance is limited. The purpose of this study was to determine whether laser guidance use on a mini C-arm fluoroscopy unit can reduce radiation exposure. Methods: Surgeons (N = 25) performed the same simulated surgical task, which involved obtaining “perfect circle” views of 2 cannulated screws placed into a cadaveric wrist, done with and without C-arm laser guidance. The testing order was randomized. Main outcomes were time to complete the task, number of shots required to complete the task, number of blank shots taken, radiation exposure, total dose area product (DAP), and total exposure time. Results: Laser guidance significantly reduced the percentage of surgeons who took blank shots, from 88% of the group without the laser to 12% of the group with the laser, and decreased the total average blank shots in the group from 3.5 to 0.1. While we found laser guidance led to shorter time to complete the task, decreased shots taken, and decreased exposure time and DAP, these findings only approached significance. Conclusion: While debate continues regarding whether mini or standard C-arm is safest, it is clear that decreasing the overall number of exposures limits potential adverse effects. Our study demonstrated that when using a mini C-arm, laser guidance decreases the number of exposures required to capture an image. These findings warrant a larger study to define the specific exposure savings and indicate potential benefit of mini C-arm use with laser guidance.