In Vitro Comparison of Pulsed-Thulium:YAG, Holmium:YAG, and Thulium Fiber Laser.

Autor: Chicaud M; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, Paris, France.; PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, Paris, France.; Service d'Urologie, CHU Limoges, Limoges, France., Kutchukian S; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, Paris, France.; PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, Paris, France.; Department of Urology, Poitiers University Hospital, Poitiers, France., Berthe L; PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, Paris, France., Corrales M; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, Paris, France.; Progressive Endourological Association for Research and Leading Solutions (PEARLS), Paris, France., Solano C; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, Paris, France.; Department of Endourology, Uroclin SAS Medellin, Medellin, Colombia., Candela L; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, Paris, France.; Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.; Vital-Salute San Raffaele University, Milan, Italy., Doizi S; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, Paris, France.; PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, Paris, France., Smith D; Department of Urology, Westmoreland Street Hospital, UCLH NHS Foundation Trust, London, United Kingdom.; Endourology Academy, London, United Kingdom.; Social Media Committee, Endourological Society, London, United Kingdom., Traxer O; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, Paris, France.; PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, Paris, France.; Progressive Endourological Association for Research and Leading Solutions (PEARLS), Paris, France., Panthier F; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, Paris, France.; PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, Paris, France.; Progressive Endourological Association for Research and Leading Solutions (PEARLS), Paris, France.; Department of Urology, Westmoreland Street Hospital, UCLH NHS Foundation Trust, London, United Kingdom.
Jazyk: angličtina
Zdroj: Journal of endourology [J Endourol] 2024 Dec; Vol. 38 (12), pp. 1427-1435. Date of Electronic Publication: 2024 Oct 01.
DOI: 10.1089/end.2024.0424
Abstrakt: Objective: To characterize the pulse characteristics and risk of fiber fracture (ROF) of the pulsed-Thulium:YAG (p-Tm:YAG) laser and to compare its ablation volumes (AVs) against Holmium:Yttrium-Aluminium-Garnet (Ho:YAG) laser and Thulium fiber laser (TFL). Materials and Methods: p-Tm:YAG (100 W-Thulio, Dornier-Medtech © , Germany) was characterized using single-use 272 μm core-diameter-fibers. p-Tm:YAG characterization included pulse shape, duration, and peak power (PP) studies. ROF was assessed after 5 minutes of continuous laser activation (CLA) at five decreasing fiber bend radii (1, 0.9, 0.75, 0.6, and 0.45 cm). p-Tm:YAG, Ho:YAG (120 W-Cyber-Ho, Quanta ® , USA), and TFL (60 W-TFLDrive, Coloplast ® , Denmark) AVs were compared using a 20-mm linear CLA at 2 mm/second velocity in contact with 20 mm 3 hard stone phantoms (HSP) and soft stone phantoms (SSP) (15:3 and 15:5 water to powder ratio, respectively) fully submerged in saline at 0.5 J-20 Hz or 1 J-10 Hz. After CLA, phantoms underwent three-dimensional (3D) micro-scanning (CT) and subsequent 3D segmentation to estimate the AVs, using 3DSlicer © . Each experiment was performed in triplicate. Results: p-Tm:YAG presents a uniform pulse profile in all of the available preset modes. PP ranged from 564 to 2199 W depending on pulse mode. No laser fiber fracture occurred at any bend radius. p-Tm:YAG achieved similar mean AVs to TFL and Ho:YAG for HSP (8.96 ± 3.1 vs 9.78 ± 1.1 vs 8.8 ± 2.8 mm 3 , p = 0.67) but TFL was associated with higher AVs compared with p-Tm:YAG and Ho:YAG (12.86 ± 1.85 vs 10.12 ± 1.89 vs 7.56 ± 2.21 mm 3 , p = 0.002) against SSP. AVs for HSP increased with pulse energy for p-Tm:YAG and Ho:YAG and (11.56 ± 1.8 vs 6.36 ± 0.84 mm 3 and 11.27 ± 1.98 vs 6.34 ± 0.55 mm 3 , p = 0.03 and p = 0.02), whereas AVs for SSP were similar across laser settings for all laser sources. AVs with TFL were similar across laser settings for both phantom types. Conclusion: p-Tm:YAG combines intermediate PP between Ho:YAG and TFL, a uniform pulse profile, no ROF with increasing deflection and effective ablation rates. Further clinical studies are needed to confirm these in vitro results.
Databáze: MEDLINE
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