How much energy do we need to ablate 1 cubic millimeter of stone during Thulium Fiber Laser lithotripsy? An in vitro study.
World J Urol
; 42(1): 57, 2024 Jan 27.
Article
en En
| MEDLINE
| ID: mdl-38280001
ABSTRACT
INTRODUCTION:
Both Holmiumyttrium-aluminium-garnet (HoYAG) laser and Thulium Fiber Laser (TFL) can effectively treat all urinary stone types. This in vitro study evaluated the ablation volume per pulse (AVP) and required energy needed to ablate 1mm3 (RE, J/mm3) of various stone types at different laser settings with TFL.METHODS:
272-µm core-diameter laser fibers (Boston Scientific©) were connected to a 50 Watts TFL generator (IPG®). An experimental setup immerged human stones of calcium oxalate monohydrate (COM), uric acid (UA), and cystine (CYS) with a single pulse lasing emission (0.5/0.8/1 J), in contact mode. Stones were dried out before three-dimensional scanning to measure AVP and deduce from the pulse energy (PE) and AVP the RE. A direct comparison with known HoYAG's AVP and RE was then carried out.RESULTS:
AVP for COM stones was significantly greater than those for CYS stones and similar to UA stones (p = 0.02 and p = 0.06, respectively). If AVP increased with PE against COM and UA stones, AVP decreased against CYS stones. 1 J PE resulted in a threefold lower RE compared with other PE for COM stones. On the contrary, RE for CYS increased with PE, whereas PE did not had influence on RE for UA. TFL was associated with greater AVP for COM, but lower for UA and CYS stones compared to HoYAG laser.CONCLUSION:
This in vitro study firstly describes the ablation volume per pulse and required energy to treat a cubic millimeter of three frequent human stone types, and suggest TFL could not be suited for cystine. Therefore, stone composition could be considered when choosing the laser source for lithotripsy.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Cálculos Urinarios
/
Litotripsia por Láser
/
Nefrolitiasis
/
Terapia por Láser
/
Láseres de Estado Sólido
Límite:
Humans
Idioma:
En
Revista:
World J Urol
/
World j. urol
/
World journal of urology
Año:
2024
Tipo del documento:
Article
País de afiliación:
Francia