Effect of temporal pulse shape on urinary stone phantom retropulsion rate and ablation efficiency using holmium:YAG and super-pulse thulium fibre lasers.
ablation
holmium:YAG
lithotripsy
retropulsion
thulium fibre laser
Journal
BJU international
ISSN: 1464-410X
Titre abrégé: BJU Int
Pays: England
ID NLM: 100886721
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
pubmed:
12
4
2020
medline:
1
12
2020
entrez:
12
4
2020
Statut:
ppublish
Résumé
To investigate the effects of laser temporal pulse shaping of the super-pulse thulium fibre laser (SPTFL) and to compare these in controlled in vitro conditions with various holmium: yttrium aluminium garnet (Ho:YAG) pulse delivery modes. The SPTFL (Urolase SP, IRE-Polus, Fryazino, Russia), with an emission wavelength of 1.94 μm, and a Ho:YAG laser (P120H; Lumenis, Yokneam, Israel) with Moses technology were compared. Pulse shape, stone retropulsion and ablation efficiency were evaluated using BegoStones and compared for each laser mode: short (SP), long (LP), and Moses pulse (MP) for Ho:YAG, regular pulse (RP) and dual pulse (DP) for SPTFL. The Ho:YAG SP mode exhibited an asymmetrical pulse shape, with a steep leading slope and a much more gradual trailing slope, without any flat section. Pulses generated by the SPTFL were significantly longer and therefore had lower peak power than those generated by the Ho:YAG laser at equivalent energy settings. Retropulsion for the holmium:YAG LP and MP modes was similar and lower than that for the SP mode, but higher than for the SPTFL (all P ≤ 0.02), with an average stone displacement approximately four times and two times lower for SPTFL as compared to the Ho:YAG laser. Comparison of ablation volumes indicated that the SPTFL induced significantly higher (twofold) ablation than the Ho:YAG laser. The magnitude and initial velocity of stone retropulsion decreased with longer pulse duration and lower pulse peak power, without sacrificing ablation efficiency. These observations are manifest when comparing the Ho:YAG laser with the SPTFL. The novel SPTFL provides greater versatility and control of pulse variables than the Ho:YAG laser. Further clinical investigation of practical benefits achievable with pulse-shaping SPTFL modes is warranted.
Substances chimiques
Thulium
8RKC5ATI4P
Holmium
W1XX32SQN1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
159-167Informations de copyright
© 2020 The Authors BJU International © 2020 BJU International Published by John Wiley & Sons Ltd.
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