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Erschienen in: World Journal of Urology 11/2020

27.01.2020 | Original Article

How much energy do we need to ablate 1 mm3 of stone during Ho:YAG laser lithotripsy? An in vitro study

verfasst von: Frédéric Panthier, Eugenio Ventimiglia, Laurent Berthe, Catherine Chaussain, Michel Daudon, Steeve Doizi, Olivier Traxer

Erschienen in: World Journal of Urology | Ausgabe 11/2020

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Abstract

Introduction

Holmium:yttrium–aluminium–garnet (Ho:YAG) is currently the gold standard for lithotripsy for the treatment of all known urinary stone types. Stone composition and volume are major determinants of the lithotripsy. This in vitro study evaluated the required energy to ablate 1 mm3 of various stone types with different laser settings using Ho:YAG.

Methods

272 µm core-diameter laser fibers (Boston Scientific©) were connected to a 30 Watt MH1 Ho:YAG generator (Rocamed®). An experimental setup consisting of immerged human stones of calcium oxalate monohydrate (COM), uric acid (UA) or cystine (Cys) was used with a single pulse lasing emission (0.6/0.8/1 J), in contact mode. Stones were dried out before three-dimensional scanning to measure ablation volume per pulse (AVP) and required energy to treat 1 mm3 (RE).

Results

All settings considered, ablation volumes per pulse (AVP) for COM were significantly lower than those for UA and Cys (p = 0.002 and p = 0.03, respectively), whereas AVP for Cys was significantly lower than those for UA (p = 0.03). The mean REs at 0.6 J pulse energy (PE) for COM, Cys and UA were 34, 8.5 and 3.2 J, respectively The mean REs at 1 J PE for COM, Cys and UA were 14.7, 6.4 and 2 J, respectively. At 0.6 J PE, RE for COM was more than tenfold and fivefold higher than those for UA and Cys, respectively.

Conclusion

This in vitro study shows for the first time a volumetric evaluation of Ho:YAG efficiency by the ablation volume per pulse on human stone samples, according to various pulse energies. The REs for COM, UA and Cys should be considered in clinical practice.
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Metadaten
Titel
How much energy do we need to ablate 1 mm3 of stone during Ho:YAG laser lithotripsy? An in vitro study
verfasst von
Frédéric Panthier
Eugenio Ventimiglia
Laurent Berthe
Catherine Chaussain
Michel Daudon
Steeve Doizi
Olivier Traxer
Publikationsdatum
27.01.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 11/2020
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-020-03091-5

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