On-line version ISSN 2078-5151
S. Afr. j. surg. vol.50 n.2 Cape Town May. 2012
B. van der Merwe
M.Tech.; School of Health Technology, Central University of Technology, Bloemfontein
OBJECTIVES: To evaluate the effects of ionising radiation and radiation limits, and measure radiation doses received by surgeons in theatre.
DESIGN: Thermoluminescent dosimeter measurements of accumulated dose to specific anatomical regions of a neurosurgeon, gastroenterologist and orthopaedic surgeon performing fluoroscopy on 39 patients undergoing treatment for back pain, 7 for endoscopic retrograde cholangiopancreatography procedures, and 48 for orthopaedic operations respectively.
RESULTS: Radiation dose levels with the X-ray tube above the table during back pain procedures exceeded the occupational annual recommendation to the neurosurgeon's hands. The protocol regarding the orientation of the C-arm was changed. Convincing evidence of the importance and effectiveness of lead shielding was recorded.
CONCLUSIONS: Constant revision of protocols should apply the as-low-as-reasonably-achievable principle in every unique setting. The ideal is to position the image intensifier above the theatre table. The longest possible distance from the source will lower radiation risk. Full-body protection of 0.35 mm lead equivalence during fluoroscopy is mandatory.
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