Steady-state versus burst lasing techniques for thulium fiber laser.
Burst
Continuous
Laser efficacy
Laser settings
Thermal damage
Thulium fiber laser
Urinary stones
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
19 Aug 2024
19 Aug 2024
Historique:
received:
19
02
2024
accepted:
01
06
2024
medline:
19
8
2024
pubmed:
19
8
2024
entrez:
19
8
2024
Statut:
epublish
Résumé
To evaluate the stone ablation rate and direct thermal damage from thulium fiber laser (TFL) lithotripsy using continuous (C) and burst (B) lasing techniques on an in vitro ureteral model. The TFL Drive (Coloplast, Humlebaek, Denmark) was used in an in vitro saline-submerged ureteral model. Ten participants, including five junior and five experienced urologists, conducted the experimental setup with 7 different settings comparing two lasing techniques: steady-state lasing (0.5 J/10 Hz = 5W for 300 s and 0.5 J/20 Hz = 10W for 150 s) and burst, intermittent 5 s on/off lasing (0.5 J/20 Hz, 0.5 J/30 Hz, 0.5 J/60 Hz, 0.1 J/200 Hz, and 0.05 J/400 Hz) with a target cumulative energy of 1500 J using cubic 125 mm The were no significant differences in stone ablation mass neither between C and B lasing techniques, nor between expertise levels. At C lasing technique had only mild ureteral lesions with no significant differences between expertise levels (p: 0.97) or laser settings (p: 0.71). At B lasing technique, different types of thermal lesions were found with no expertise (p: 0.11) or setting (p: 0.83) differences. However, B laser setting had higher grade direct thermal lesions than C (p: 0.048). Regarding efficacy, C and B lasing techniques achieve comparable stone ablation rates. Safety-wise, B lasing mode showed higher grade of direct thermal lesions. These results should be further investigated to verify which of the lasing mode is the safest in vivo. Until then and unless proven otherwise, a C mode with low frequency should be recommended to avoid ureteral wall lesions.
Identifiants
pubmed: 39158747
doi: 10.1007/s00345-024-05102-1
pii: 10.1007/s00345-024-05102-1
doi:
Substances chimiques
Thulium
8RKC5ATI4P
Types de publication
Journal Article
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
487Informations de copyright
© 2024. The Author(s).
Références
Sofer M, Watterson JD, Wollin TA, Nott L, Razvi H, Denstedt JD (2002) Holmium:YAG laser lithotripsy for upper urinary tract calculi in 598 patients. J Urol 167(1):31–34. https://doi.org/10.1016/s0022-5347(05)65376-1
doi: 10.1016/s0022-5347(05)65376-1
pubmed: 11743269
Geraghty RM, Davis NF, Tzelves L, Lombardo R, Yuan C, Thomas K, Petrik A, Neisius A, Türk C, Gambaro G, Skolarikos A, Somani BK (2023) best practice in interventional management of urolithiasis: an update from the European Association of Urology guidelines panel for urolithiasis 2022. Eur Urol Focus 9(1):199–208. https://doi.org/10.1016/j.euf.2022.06.014 . (Epub 2022 Aug 1)
doi: 10.1016/j.euf.2022.06.014
pubmed: 35927160
Kronenberg P, Traxer O (2019) The laser of the future: reality and expectations about the new thulium fiber laser—a systematic review. Transl Androl Urol 8(Suppl 4):S398–S417. https://doi.org/10.21037/tau.2019.08.01
doi: 10.21037/tau.2019.08.01
pubmed: 31656746
pmcid: 6790412
Traxer O, Keller EX (2020) Thulium fiber laser: the new player for kidney stone treatment? A comparison with Holmium:YAG laser. World J Urol 38(8):1883–1894. https://doi.org/10.1007/s00345-019-02654-5 . (Epub 2019 Feb 6)
doi: 10.1007/s00345-019-02654-5
pubmed: 30729311
Hardy LA, Vinnichenko V, Fried NM (2019) High power holmium:YAG versus thulium fiber laser treatment of kidney stones in dusting mode: ablation rate and fragment size studies. Lasers Surg Med 51(6):522–530. https://doi.org/10.1002/lsm.23057 . (Epub 2019 Jan 16)
doi: 10.1002/lsm.23057
pubmed: 30648761
Basulto-Martínez M, Proietti S, Pavia MP, Yeow Y, Eisner BH, Giusti G (2023) Understanding the ablation rate of holmium:YAG and thulium fiber lasers. Perspectives from an in vitro study. Urolithiasis. 51(1):32. https://doi.org/10.1007/s00240-022-01402-6
doi: 10.1007/s00240-022-01402-6
pubmed: 36648558
pmcid: 9845154
Chua ME, Bobrowski A, Ahmad I, Kim JK, Silangcruz JM, Rickard M, Lorenzo A, Lee JY (2023) Thulium fibre laser vs holmium: yttrium-aluminium-garnet laser lithotripsy for urolithiasis: meta-analysis of clinical studies. BJU Int 131(4):383–394. https://doi.org/10.1111/bju.15921 . (Epub 2022 Nov 23)
doi: 10.1111/bju.15921
pubmed: 36260370
De Coninck V, Keller EX, Somani B, Giusti G, Proietti S, Rodriguez-Socarras M, Rodríguez-Monsalve M, Doizi S, Ventimiglia E, Traxer O (2020) Complications of ureteroscopy: a complete overview. World J Urol 38(9):2147–2166. https://doi.org/10.1007/s00345-019-03012-1 . (Epub 2019 Nov 20)
doi: 10.1007/s00345-019-03012-1
pubmed: 31748953
Tonyali S, Yilmaz M, Tzelves L, Emiliani E, De Coninck V, Keller EX, Miernik A (2023) Predictors of ureteral strictures after retrograde ureteroscopic treatment of impacted ureteral stones: a systematic literature review. J Clin Med 12(10):3603. https://doi.org/10.3390/jcm12103603
doi: 10.3390/jcm12103603
pubmed: 37240709
pmcid: 10218913
https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRES/res.cfm?id=188172
Perri D, Besana U, Mazzoleni F, Pacchetti A, Morini E, Verzotti E, Maltagliati M, Romero-Otero J, Pastore AL, Gozen AS et al (2024) A Comparison between vapor tunnel and virtual basket for the treatment of proximal ureteral stones using holmium:YAG laser (Cyber Ho): which is the best tool to reduce retropulsion? World J Urol 42:244. https://doi.org/10.1007/s00345-024-04961-y
doi: 10.1007/s00345-024-04961-y
pubmed: 38642145
Corrales M, Panthier F, Solano C, Candela L, Traxer O (2023) Laser safety, warnings, and limits in retrograde intrarenal surgery. Actas Urol Esp (Engl Ed). https://doi.org/10.1016/j.acuroe.2023.06.009 . (English, Spanish. Epub ahead of print)
doi: 10.1016/j.acuroe.2023.06.009
pubmed: 37657708
Sierra A, Corrales M, Kolvatzis M, Panthier F, Piñero A, Traxer O (2022) Thermal injury and laser efficiency with holmium YAG and thulium fiber laser—an in vitro study. J Endourol 36(12):1599–1606. https://doi.org/10.1089/end.2022.0216
doi: 10.1089/end.2022.0216
pubmed: 35793107
Enikeev D, Taratkin M, Klimov R et al (2020) Superpulsed thulium fiber laser for stone dusting: in search of a perfect ablation regimen—a prospective single-center study. J Endourol 34:1175–1179
doi: 10.1089/end.2020.0519
pubmed: 32560595
Doizi S, Traxer O (2018) Flexible ureteroscopy: technique, tips and tricks. Urolithiasis 46(1):47–58. https://doi.org/10.1007/s00240-017-1030-x . (Epub 2017 Dec 8)
doi: 10.1007/s00240-017-1030-x
pubmed: 29222575
Esch E, Simmons WN, Sankin G et al (2010) A simple method for fabricating artificial kidney stones of different physical properties. Urol Res 38(4):315–319
doi: 10.1007/s00240-010-0298-x
pubmed: 20652562
pmcid: 3752343
Panthier F, Germain T, Gorny C, Berthe L, Doizi S, Traxer O (2021) Laser fiber displacement velocity during Tm-fiber and Ho:YAG laser lithotripsy: introducing the concept of optimal displacement velocity. J Clin Med 11(1):181
doi: 10.3390/jcm11010181
pubmed: 35011922
pmcid: 8745998
Kwok JL, De Coninck V, Ventimiglia E, Panthier F, Corrales M, Sierra A, Emiliani E, Talso M, Miernik A, Kronenberg P, Enikeev D, Somani B, Ghani KR, Traxer O, Keller EX (2023) Laser ablation efficiency, laser ablation speed, and laser energy consumption during lithotripsy: what are they and how are they defined? A systematic review and proposal for a standardized terminology. Eur Urol Focus. https://doi.org/10.1016/j.euf.2023.10.004 . (Epub ahead of print)
doi: 10.1016/j.euf.2023.10.004
pubmed: 37940392
Sierra A, Corrales M, Piñero A, Traxer O (2022) Thulium fiber laser pre-settings during ureterorenoscopy: Twitter’s experts’ recommendations. World J Urol 40(6):1529–1535. https://doi.org/10.1007/s00345-022-03966-9 . (Epub 2022 Mar 4)
doi: 10.1007/s00345-022-03966-9
pubmed: 35246704
Sierra A, Corrales M, Piñero A, Kolvatzis M, Somani B, Traxer O (2022) Glossary of pre-settings given by laser companies: no consensus! World J Urol 40(9):2313–2321. https://doi.org/10.1007/s00345-022-04090-4 . (Epub 2022 Aug 7)
doi: 10.1007/s00345-022-04090-4
pubmed: 35933626
Ventimiglia E, Pauchard F, Quadrini F, Sindhubodee S, Kamkoum H, Jiménez Godínez A, Doizi S, Traxer O (2021) High- and low-power laser lithotripsy achieves similar results: a systematic review and meta-analysis of available clinical series. J Endourol 35(8):1146–1152. https://doi.org/10.1089/end.2020.0090 . (Epub 2021 May 24)
doi: 10.1089/end.2020.0090
pubmed: 33677987
De Coninck V, Hente R, Claessens M, Duchateau A, Doizi S, Keller EX (2021) High-power, high-frequency Ho:YAG lasers are not essential for retrograde intrarenal surgery. Eur Urol Focus 7(1):5–6. https://doi.org/10.1016/j.euf.2020.12.007 . (Epub 2020 Dec 26)
doi: 10.1016/j.euf.2020.12.007
pubmed: 33376057
Molina WR, Carrera RV, Chew BH, Knudsen BE (2021) Temperature rise during ureteral laser lithotripsy: comparison of super pulse thulium fiber laser (SPTF) vs high power 120 W holmium- YAG laser (Ho:YAG). World J Urol. https://doi.org/10.1007/s00345-021-03619-3
doi: 10.1007/s00345-021-03619-3
pubmed: 33604733
Aldoukhi AH, Hall TL, Ghani KR, Maxwell AD, MacConaghy B, Roberts WW (2018) Caliceal fluid temperature during high-power holmium laser lithotripsy in an in vivo porcine model. J Endourol 32(8):724–729
doi: 10.1089/end.2018.0395
pubmed: 29905092
pmcid: 6096348
Aldoukhi AH, Ghani KR, Hall TL, Roberts WW (2017) Thermal response to high-power holmium laser lithotripsy. J Endourol 31(12):1308–2131
doi: 10.1089/end.2017.0679
pubmed: 29048216
Taratkin M, Laukhtina E, Singla N et al (2020) Temperature changes during laser lithotripsy with Ho:YAG laser and novel Tm-fiber laser: a comparative in-vitro study. World J Urol 38(12):3261–3266
doi: 10.1007/s00345-020-03122-1
pubmed: 32078706
Marom R, Dau JJ, Ghani KR, Hall TL, Roberts WW (2024) Assessing renal tissue temperature changes and perfusion effects during laser activation in an in vivo porcine model. World J Urol 42(1):197. https://doi.org/10.1007/s00345-024-04896-4
doi: 10.1007/s00345-024-04896-4
pubmed: 38530484
Wanderling C, Saxton A, Phan D, Doersch K, Shepard L, Schuler N, Osinski T, Quarrier S, Ghazi A (2024) WATTS happening? Evaluation of thermal dose during holmium laser lithotripsy in a high-fidelity anatomic model. World J Urol 42(1):157. https://doi.org/10.1007/s00345-024-04821-9
doi: 10.1007/s00345-024-04821-9
pubmed: 38483596