Thulium fiber laser lithotripsy in an in vitro ureter model.
Identifieur interne : 000122 ( PubMed/Corpus ); précédent : 000121; suivant : 000123Thulium fiber laser lithotripsy in an in vitro ureter model.
Auteurs : Luke A. Hardy ; Christopher R. Wilson ; Pierce B. Irby ; Nathaniel M. FriedSource :
- Journal of biomedical optics [ 1560-2281 ] ; 2014.
English descriptors
- KwdEn :
- MESH :
- chemical , chemistry : Thulium.
- methods : Lithotripsy, Laser.
- surgery : Ureter, Urinary Calculi.
- therapeutic use : Lasers, Solid-State.
- Humans, Models, Biological, Temperature.
Abstract
Using a validated in vitro ureter model for laser lithotripsy, the performance of an experimental thulium fiber laser (TFL) was studied and compared to the clinical gold standard holmium:YAG laser. The holmium laser (λ = 2120 nm) was operated with standard parameters of 600 mJ, 350 μs, 6 Hz, and 270-μm-core optical fiber. The TFL (λ=1908 nm) was operated with 35 mJ, 500 μs, 150 to 500 Hz, and a 100-μm-core fiber. Urinary stones (60% calcium oxalate monohydrate/40% calcium phosphate) of uniform mass and diameter (4 to 5 mm) were laser ablated with fibers through a flexible video-ureteroscope under saline irrigation with flow rates of 22.7 and 13.7 ml/ min for the TFL and holmium laser, respectively. The temperature 3 mm from the tube's center and 1 mm above the mesh sieve was measured by a thermocouple and recorded throughout each experiment for both lasers. Total laser and operation times were recorded once all stone fragments passed through a 1.5-mm sieve. The holmium laser time measured 167±41 s (n=12). TFL times measured 111±49, 39±11, and 23±4 s, for pulse rates of 150, 300, and 500 Hz, respectively (n=12 each). Mean peak saline irrigation temperatures reached 24±1°C for holmium, and 33±3°C, 33±7°C, and 39±6°C, for TFL at pulse rates of 150, 300, and 500 Hz, respectively. To avoid thermal buildup and provide a sufficient safety margin, TFL lithotripsy should be performed with pulse rates below 500 Hz and/or increased saline irrigation rates. The TFL rapidly fragmented kidney stones due in part to its high pulse rate, high power density, high average power, and observation of reduced stone retropulsion and may provide a clinical alternative to the conventional holmium laser for lithotripsy.
DOI: 10.1117/1.JBO.19.12.128001
PubMed: 25518001
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Thulium fiber laser lithotripsy in an in vitro ureter model.</title><author><name sortKey="Hardy, Luke A" sort="Hardy, Luke A" uniqKey="Hardy L" first="Luke A" last="Hardy">Luke A. Hardy</name><affiliation><nlm:affiliation>University of North Carolina at Charlotte, Department of Physics and Optical Science, 9201 University City Avenue, Charlotte, North Carolina 28223-0001, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Wilson, Christopher R" sort="Wilson, Christopher R" uniqKey="Wilson C" first="Christopher R" last="Wilson">Christopher R. Wilson</name><affiliation><nlm:affiliation>University of North Carolina at Charlotte, Department of Physics and Optical Science, 9201 University City Avenue, Charlotte, North Carolina 28223-0001, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Irby, Pierce B" sort="Irby, Pierce B" uniqKey="Irby P" first="Pierce B" last="Irby">Pierce B. Irby</name><affiliation><nlm:affiliation>McKay Department of Urology, Carolinas Medical Center, 1024 Edgehill Road South, Charlotte, North Carolina 28207, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Fried, Nathaniel M" sort="Fried, Nathaniel M" uniqKey="Fried N" first="Nathaniel M" last="Fried">Nathaniel M. Fried</name><affiliation><nlm:affiliation>University of North Carolina at Charlotte, Department of Physics and Optical Science, 9201 University City Avenue, Charlotte, North Carolina 28223-0001, United StatesbMcKay Department of Urology, Carolinas Medical Center, 1024 Edgehill Road South, Charlot.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2014">2014</date><idno type="doi">10.1117/1.JBO.19.12.128001</idno><idno type="RBID">pubmed:25518001</idno><idno type="pmid">25518001</idno><idno type="wicri:Area/PubMed/Corpus">000122</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000122</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Thulium fiber laser lithotripsy in an in vitro ureter model.</title><author><name sortKey="Hardy, Luke A" sort="Hardy, Luke A" uniqKey="Hardy L" first="Luke A" last="Hardy">Luke A. Hardy</name><affiliation><nlm:affiliation>University of North Carolina at Charlotte, Department of Physics and Optical Science, 9201 University City Avenue, Charlotte, North Carolina 28223-0001, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Wilson, Christopher R" sort="Wilson, Christopher R" uniqKey="Wilson C" first="Christopher R" last="Wilson">Christopher R. Wilson</name><affiliation><nlm:affiliation>University of North Carolina at Charlotte, Department of Physics and Optical Science, 9201 University City Avenue, Charlotte, North Carolina 28223-0001, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Irby, Pierce B" sort="Irby, Pierce B" uniqKey="Irby P" first="Pierce B" last="Irby">Pierce B. Irby</name><affiliation><nlm:affiliation>McKay Department of Urology, Carolinas Medical Center, 1024 Edgehill Road South, Charlotte, North Carolina 28207, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Fried, Nathaniel M" sort="Fried, Nathaniel M" uniqKey="Fried N" first="Nathaniel M" last="Fried">Nathaniel M. Fried</name><affiliation><nlm:affiliation>University of North Carolina at Charlotte, Department of Physics and Optical Science, 9201 University City Avenue, Charlotte, North Carolina 28223-0001, United StatesbMcKay Department of Urology, Carolinas Medical Center, 1024 Edgehill Road South, Charlot.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Journal of biomedical optics</title><idno type="eISSN">1560-2281</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Humans</term><term>Lasers, Solid-State (therapeutic use)</term><term>Lithotripsy, Laser (methods)</term><term>Models, Biological</term><term>Temperature</term><term>Thulium (chemistry)</term><term>Ureter (surgery)</term><term>Urinary Calculi (surgery)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="chemistry" xml:lang="en"><term>Thulium</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Lithotripsy, Laser</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Ureter</term><term>Urinary Calculi</term></keywords><keywords scheme="MESH" qualifier="therapeutic use" xml:lang="en"><term>Lasers, Solid-State</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Models, Biological</term><term>Temperature</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Using a validated in vitro ureter model for laser lithotripsy, the performance of an experimental thulium fiber laser (TFL) was studied and compared to the clinical gold standard holmium:YAG laser. The holmium laser (λ = 2120 nm) was operated with standard parameters of 600 mJ, 350 μs, 6 Hz, and 270-μm-core optical fiber. The TFL (λ=1908 nm) was operated with 35 mJ, 500 μs, 150 to 500 Hz, and a 100-μm-core fiber. Urinary stones (60% calcium oxalate monohydrate/40% calcium phosphate) of uniform mass and diameter (4 to 5 mm) were laser ablated with fibers through a flexible video-ureteroscope under saline irrigation with flow rates of 22.7 and 13.7 ml/ min for the TFL and holmium laser, respectively. The temperature 3 mm from the tube's center and 1 mm above the mesh sieve was measured by a thermocouple and recorded throughout each experiment for both lasers. Total laser and operation times were recorded once all stone fragments passed through a 1.5-mm sieve. The holmium laser time measured 167±41 s (n=12). TFL times measured 111±49, 39±11, and 23±4 s, for pulse rates of 150, 300, and 500 Hz, respectively (n=12 each). Mean peak saline irrigation temperatures reached 24±1°C for holmium, and 33±3°C, 33±7°C, and 39±6°C, for TFL at pulse rates of 150, 300, and 500 Hz, respectively. To avoid thermal buildup and provide a sufficient safety margin, TFL lithotripsy should be performed with pulse rates below 500 Hz and/or increased saline irrigation rates. The TFL rapidly fragmented kidney stones due in part to its high pulse rate, high power density, high average power, and observation of reduced stone retropulsion and may provide a clinical alternative to the conventional holmium laser for lithotripsy.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">25518001</PMID><DateCreated><Year>2014</Year><Month>12</Month><Day>18</Day></DateCreated><DateCompleted><Year>2015</Year><Month>07</Month><Day>30</Day></DateCompleted><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1560-2281</ISSN><JournalIssue CitedMedium="Internet"><Volume>19</Volume><Issue>12</Issue><PubDate><Year>2014</Year><Month>Dec</Month></PubDate></JournalIssue><Title>Journal of biomedical optics</Title><ISOAbbreviation>J Biomed Opt</ISOAbbreviation></Journal><ArticleTitle>Thulium fiber laser lithotripsy in an in vitro ureter model.</ArticleTitle><Pagination><MedlinePgn>128001</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1117/1.JBO.19.12.128001</ELocationID><Abstract><AbstractText>Using a validated in vitro ureter model for laser lithotripsy, the performance of an experimental thulium fiber laser (TFL) was studied and compared to the clinical gold standard holmium:YAG laser. The holmium laser (λ = 2120 nm) was operated with standard parameters of 600 mJ, 350 μs, 6 Hz, and 270-μm-core optical fiber. The TFL (λ=1908 nm) was operated with 35 mJ, 500 μs, 150 to 500 Hz, and a 100-μm-core fiber. Urinary stones (60% calcium oxalate monohydrate/40% calcium phosphate) of uniform mass and diameter (4 to 5 mm) were laser ablated with fibers through a flexible video-ureteroscope under saline irrigation with flow rates of 22.7 and 13.7 ml/ min for the TFL and holmium laser, respectively. The temperature 3 mm from the tube's center and 1 mm above the mesh sieve was measured by a thermocouple and recorded throughout each experiment for both lasers. Total laser and operation times were recorded once all stone fragments passed through a 1.5-mm sieve. The holmium laser time measured 167±41 s (n=12). TFL times measured 111±49, 39±11, and 23±4 s, for pulse rates of 150, 300, and 500 Hz, respectively (n=12 each). Mean peak saline irrigation temperatures reached 24±1°C for holmium, and 33±3°C, 33±7°C, and 39±6°C, for TFL at pulse rates of 150, 300, and 500 Hz, respectively. To avoid thermal buildup and provide a sufficient safety margin, TFL lithotripsy should be performed with pulse rates below 500 Hz and/or increased saline irrigation rates. The TFL rapidly fragmented kidney stones due in part to its high pulse rate, high power density, high average power, and observation of reduced stone retropulsion and may provide a clinical alternative to the conventional holmium laser for lithotripsy.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hardy</LastName><ForeName>Luke A</ForeName><Initials>LA</Initials><AffiliationInfo><Affiliation>University of North Carolina at Charlotte, Department of Physics and Optical Science, 9201 University City Avenue, Charlotte, North Carolina 28223-0001, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wilson</LastName><ForeName>Christopher R</ForeName><Initials>CR</Initials><AffiliationInfo><Affiliation>University of North Carolina at Charlotte, Department of Physics and Optical Science, 9201 University City Avenue, Charlotte, North Carolina 28223-0001, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Irby</LastName><ForeName>Pierce B</ForeName><Initials>PB</Initials><AffiliationInfo><Affiliation>McKay Department of Urology, Carolinas Medical Center, 1024 Edgehill Road South, Charlotte, North Carolina 28207, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fried</LastName><ForeName>Nathaniel M</ForeName><Initials>NM</Initials><AffiliationInfo><Affiliation>University of North Carolina at Charlotte, Department of Physics and Optical Science, 9201 University City Avenue, Charlotte, North Carolina 28223-0001, United StatesbMcKay Department of Urology, Carolinas Medical Center, 1024 Edgehill Road South, Charlot.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Biomed Opt</MedlineTA><NlmUniqueID>9605853</NlmUniqueID><ISSNLinking>1083-3668</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>8RKC5ATI4P</RegistryNumber><NameOfSubstance UI="D013932">Thulium</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D053844">Lasers, Solid-State</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000627">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D017602">Lithotripsy, Laser</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000379">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008954">Models, Biological</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D013696">Temperature</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D013932">Thulium</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000737">chemistry</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D014513">Ureter</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000601">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D014545">Urinary Calculi</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000601">surgery</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2014</Year><Month>9</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2014</Year><Month>11</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2014</Year><Month>12</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2014</Year><Month>12</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2015</Year><Month>8</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pii">2085722</ArticleId><ArticleId IdType="doi">10.1117/1.JBO.19.12.128001</ArticleId><ArticleId IdType="pubmed">25518001</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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