MP35-12 ASSESSMENT OF DUST QUALITY WHILE ABLATING WITH THULIUM FIBER LASER, AN IN VITRO STUDY (2023)

You have accessJournal of UrologyCME1 Apr 2023MP35-12 ASSESSMENT OF DUST QUALITY WHILE ABLATING WITH THULIUM FIBER LASER, AN IN VITRO STUDY Francois Soto Palou, Robert Medairos, Junqin Chen, Jodi Antonelli, Michael Lipkin, Glenn Preminger, and Pei Zhong Francois Soto PalouFrancois Soto Palou More articles by this author , Robert MedairosRobert Medairos More articles by this author , Junqin ChenJunqin Chen More articles by this author , Jodi AntonelliJodi Antonelli More articles by this author , Michael LipkinMichael Lipkin More articles by this author , Glenn PremingerGlenn Preminger More articles by this author , and Pei ZhongPei Zhong More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003269.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Previous benchtop studies have shown that optimal stone ablation with the thulium fiber laser (TFL) is achieved with short pulse and maximum peak power. Furthermore, in vitro TFL studies have also demonstrated that at equivalent power, the combination of higher energy and lower frequency offers the most efficient dusting settings. Holmium based benchtop studies have shown that low pulse energy produces small fragments while high pulse energy produces larger fragments.1 No such studies have been performed with the TFL platform, and thus with this study we aim to assess the quality and size of fragments produced at different pulse energies. METHODS: All tests were conducted using an IPG Photonics TLR-50W TFL system and a 200 μm fiber on “soft” (5:2) Begostone 6 mm×6 mm (H×D) phantoms. We tested six different pulse energies (0.05 J, 0.1 J, 0.2 J, 0.4 J, 0.5 J, and 1 J) at varying frequencies to produce either 10 W or 20 W of power. Our previous benchtop studies have shown that short pulse provides superior ablation, so all pulse profiles were adjusted to maximum peak power and short pulse. The laser fiber was advanced beyond the distal end of a flexible ureteroscope (Dornier AXISTM, 3.6 F working channel) and the stone phantoms were treated in a test tube filled with water and immersed in a water bath at room temperature (Figure 1). Continuous dusting was performed for 1 minute with the 10 W settings, and 30 seconds with the 20 W settings. Each pulse energy was tested three times with three different stone phantoms. Resultant fragments were sieved, dried for 24 hours and examined under the microscope. RESULTS: At all tested pulse energies, no stone phantoms were broken into large fragments. All stone materials were pulverized into small dust. When examined under the microscope, individual dust particles were smaller than 20 μm for all the tested settings (Figure 1). Exact measurements were not obtained and deemed not clinically relevant. CONCLUSIONS: Unlike Holmium lithotripsy where higher pulse energy results in larger fragments, in Thulium lithotripsy higher pulse energy did not result in increased fragment size. Reference: 1. Sea J, Jonat LM, Chew BH, Qiu J, Wang B, Hoopman J, Milner T, Teichman JM. Optimal power settings for Holmium:YAG lithotripsy. J Urol. 2012 Mar;187(3):914-9. doi: 10.1016/j.juro.2011.10.147. Epub 2012 Jan 20. PMID: 22264464. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e474 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francois Soto Palou More articles by this author Robert Medairos More articles by this author Junqin Chen More articles by this author Jodi Antonelli More articles by this author Michael Lipkin More articles by this author Glenn Preminger More articles by this author Pei Zhong More articles by this author Expand All Advertisement PDF downloadLoading ...