Details

Autor(en) / Beteiligte

• Kwok, Jia-Lun
• Ventimiglia, Eugenio
• De Coninck, Vincent
• Panthier, Frédéric
• Barghouthy, Yazeed
• Danilovic, Alexandre
• Shrestha, Anil
• Smyth, Niamh
• Schmid, Florian Alexander
• Hunziker, Manuela
• Poyet, Cédric
• Daudon, Michel
• Traxer, Olivier
• Eberli, Daniel
• Keller, Etienne Xavier

Titel

Pulsed Thulium:YAG laser – What is the lithotripsy ablation efficiency for stone dust from human urinary stones? Results from an in vitro PEARLS study

Ist Teil von

• World journal of urology, 2023-12, Vol.41 (12), p.3723-3730

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2023

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Background The novel pulsed thulium:yttrium–aluminum–garnet (p-Tm:YAG) laser was recently introduced. Current studies present promising p-Tm:YAG ablation efficiency, although all are based on non-human stone models or with unknown stone composition. The present study aimed to evaluate p-Tm:YAG ablation efficiency for stone dust from human urinary stones of known compositions. Methods Calcium oxalate monohydrate (COM) and uric acid (UA) stones were subjected to lithotripsy in vitro using a p-Tm:YAG laser generator (Thulio®, Dornier MedTech GmbH, Germany). 200 J was applied at 0.1 J × 100 Hz, 0.4 J × 25 Hz or 2.0 J × 5 Hz (average 10W). Ablated stone dust mass was calculated from weight difference between pre-lithotripsy stone and post-lithotripsy fragments > 250 µm. Estimated ablated volume was calculated using prior known stone densities (COM: 2.04 mg/mm 3 , UA: 1.55 mg/mm 3 ). Results Mean ablation mass efficiency was 0.04, 0.06, 0.07 mg/J (COM) and 0.04, 0.05, 0.06 mg/J (UA) for each laser setting, respectively. This translated to 0.021, 0.029, 0.034 mm 3 /J (COM) and 0.026, 0.030, 0.039 mm 3 /J (UA). Mean energy consumption was 26, 18, 17 J/mg (COM) and 32, 23, 17 J/mg (UA). This translated to 53, 37, 34 J/mm 3 (COM) and 50, 36, 26 J/mm 3 (UA). There were no statistically significant differences for laser settings or stone types (all p  > 0.05). Conclusion To our knowledge, this is the first study showing ablation efficiency of the p-Tm:YAG laser for stone dust from human urinary stones of known compositions. The p-Tm:YAG seems to ablate COM and UA equally well, with no statistically significant differences between differing laser settings.