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  1. Current evidence on the safety and efficacy of radially emitting laser fibre treatment of an anal fistula is limited in quantity and quality. Therefore, although there are no major safety concerns, this procedure should only be used with special arrangements  for clinical governance, consent, and audit or research.

    Recommendation ID IPG644/1 Question Current evidence on the safety and efficacy of radially emitting laser fibre treatment of an anal fistula

  2. Evidence on the safety and efficacy of artificial iris implant insertion for acquired aniridia is limited in quantity and quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research.  Find out  what special arrangements mean on the NICE website .

    Recommendation ID IPG674 Question Evidence on the safety and efficacy of artificial iris implant insertion for acquired aniridia is limited

  3. Evidence on the efficacy of open prenatal repair of open neural tube defects in the fetus is adequate in quantity and quality. However, evidence on its safety shows serious but well recognised safety concerns for the mother and fetus. Therefore, this procedure should only be used with  special arrangements   for clinical governance, consent, and audit or research.

    Recommendation ID IPG668 Question Evidence on the efficacy of open prenatal repair of open neural tube defects in the fetus is adequate

  4. The evidence on the safety of reinforcement of a permanent stoma with a synthetic or biological mesh to prevent a parastomal hernia shows there are serious but well-recognised complications. The evidence on efficacy is limited in quantity and quality. Therefore, this procedure should not be used unless  special arrangements   are in place for clinical governance, consent, and audit or research.

    Recommendation ID IPG654/1 Question The evidence on the safety of reinforcement of a permanent stoma with a synthetic or biological mesh