Temperature profile during endourological laser activation: introducing the thermal safety distance concept.

Autor: Ventimiglia E; Vita-Salute San Raffaele University, Milan, Italy. eugenio.ventimiglia@gmail.com.; Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Via Olgettina, 60, Milan, 20132, Italy. eugenio.ventimiglia@gmail.com.; Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, The Netherlands. eugenio.ventimiglia@gmail.com.; Progressive Endourological Association for Research and Leading Solutions (PEARLS), Paris, France. eugenio.ventimiglia@gmail.com., Robesti D; Vita-Salute San Raffaele University, Milan, Italy.; Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Via Olgettina, 60, Milan, 20132, Italy., Keller EX; Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, The Netherlands.; Progressive Endourological Association for Research and Leading Solutions (PEARLS), Paris, France.; Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Corsini C; Vita-Salute San Raffaele University, Milan, Italy.; Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Via Olgettina, 60, Milan, 20132, Italy., Folcia A; Vita-Salute San Raffaele University, Milan, Italy.; Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Via Olgettina, 60, Milan, 20132, Italy., Fantin M; Vita-Salute San Raffaele University, Milan, Italy.; Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Via Olgettina, 60, Milan, 20132, Italy., Candela L; Sorbonne Universite, GRC#20 Lithiase Urinaire, Hôpital Tenon, Paris, Île-de- France, 27063, France., Pozzi E; Vita-Salute San Raffaele University, Milan, Italy.; Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Via Olgettina, 60, Milan, 20132, Italy., Sierra A; Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, The Netherlands.; Progressive Endourological Association for Research and Leading Solutions (PEARLS), Paris, France.; Sorbonne Universite, GRC#20 Lithiase Urinaire, Hôpital Tenon, Paris, Île-de- France, 27063, France., Pietropaolo A; Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, The Netherlands.; Department of Urology, University Hospital Southampton, Southampton, UK., Somani BK; Department of Urology, University Hospital Southampton, Southampton, UK., Panthier F; Progressive Endourological Association for Research and Leading Solutions (PEARLS), Paris, France.; Sorbonne Universite, GRC#20 Lithiase Urinaire, Hôpital Tenon, Paris, Île-de- France, 27063, France., Pauchard F; Progressive Endourological Association for Research and Leading Solutions (PEARLS), Paris, France.; Urology Department, Hospital Naval Almirante Nef, Viña del Mar 2520000, Av. Alessandri, Viña del Mar, Valparaíso, Chile., Goumas IK; Dept. of Urology, Istituto Clinico Beato Matteo, Vigevano, Italy., Villa L; Vita-Salute San Raffaele University, Milan, Italy.; Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Via Olgettina, 60, Milan, 20132, Italy., Montorsi F; Vita-Salute San Raffaele University, Milan, Italy.; Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Via Olgettina, 60, Milan, 20132, Italy., Traxer O; Progressive Endourological Association for Research and Leading Solutions (PEARLS), Paris, France.; Sorbonne Universite, GRC#20 Lithiase Urinaire, Hôpital Tenon, Paris, Île-de- France, 27063, France., Salonia A; Vita-Salute San Raffaele University, Milan, Italy.; Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Via Olgettina, 60, Milan, 20132, Italy., Saccomandi P; Department of Mechanical Engineering, Politecnico di Milano, Milan, 20156, Italy.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2024 Jul 29; Vol. 42 (1), pp. 453. Date of Electronic Publication: 2024 Jul 29.
DOI: 10.1007/s00345-024-05162-3
Abstrakt: Purpose: To examine temporal-spatial distribution of heat generated upon laser activation in a bench model of renal calyx. To establish reference values for a safety distance between the laser fiber and healthy tissue during laser lithotripsy.
Methods: We developed an in-vitro experimental setup employing a glass pipette and laser activation under various intra-operative parameters, such as power and presence of irrigation. A thermal camera was used to monitor both temporal and spatial temperature changes during uninterrupted 60-second laser activation. We computed the thermal dose according to Sapareto and Dewey's formula at different distances from the laser fiber tip, in order to determine a safety distance.
Results: A positive correlation was observed between average power and the highest recorded temperature (Spearman's coefficient 0.94, p < 0.001). Irrigation was found to reduce the highest recorded temperature, with a maximum average reduction of 9.4 °C at 40 W (p = 0.002). A positive correlation existed between average power and safety distance values (Spearman's coefficient 0.86, p = 0.001). A thermal dose indicative of tissue damage was observed at 20 W without irrigation (safety distance 0.93±0.11 mm). While at 40 W, irrigation led to slight reduction in mean safety distance (4.47±0.85 vs. 5.22±0.09 mm, p = 0.08).
Conclusions: Laser settings with an average power greater than 10 W deliver a thermal dose indicative of tissue damage, which increases with higher average power values. According to safety distance values from this study, a maximum of 10 W should be used in the ureter, and a maximum of 20 W should be used in kidney in presence of irrigation.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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