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Does stone entrapment with ″Uro-Net″ improve Ho:YAG laser lithotripsy efficiency in percutaneous nephrolithotomy and cystolithopaxy?: an in vitro study.
Int Braz J Urol. 2013 Jul-Aug; 39(4):579-86.IB

Abstract

PURPOSE

to test the effect of stone entrapment on laser lithotripsy efficiency.

MATERIALS AND METHODS

Spherical stone phantoms were created using the BegoStone® plaster. Lithotripsy of one stone (1.0 g) per test jar was performed with Ho:YAG laser (365 µm fiber; 1 minute/trial). Four laser settings were tested: I-0.8 J,8 Hz; II-0.2J,50 Hz; III-0.5 J,50 Hz; IV-1.5 J,40 Hz. Uro-Net (US Endoscopy) deployment was used in 3/9 trials. Post-treatment, stone fragments were strained though a 1mm sieve; after a 7-day drying period fragments and unfragmented stone were weighed. Uro-Net nylon mesh and wire frame resistance were tested (laser fired for 30s). All nets used were evaluated for functionality and strength (compared to 10 new nets). Student's T test was used to compare the studied parameters; significance was set at p < 0.05.

RESULTS

Laser settings I and II caused less damage to the net overall; the mesh and wire frame had worst injuries with setting IV; setting III had an intermediate outcome; 42% of nets were rendered unusable and excluded from strength analysis. There was no difference in mean strength between used functional nets and non-used devices (8.05 vs. 7.45 lbs, respectively; p = 0.14). Setting IV was the most efficient for lithotripsy (1.9 ± 0.6 mg/s; p < 0.001) with or without net stabilization; setting III was superior to I and II only if a net was not used.

CONCLUSIONS

Laser lithotripsy is not optimized by stone entrapment with a net retrieval device which may be damaged by high energy laser settings.

Authors+Show Affiliations

Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24054387

Citation

Marchini, Giovanni Scala, et al. "Does Stone Entrapment With ″Uro-Net″ Improve Ho:YAG Laser Lithotripsy Efficiency in Percutaneous Nephrolithotomy and Cystolithopaxy?: an in Vitro Study." International Braz J Urol : Official Journal of the Brazilian Society of Urology, vol. 39, no. 4, 2013, pp. 579-86.
Marchini GS, Rai A, De S, et al. Does stone entrapment with ″Uro-Net″ improve Ho:YAG laser lithotripsy efficiency in percutaneous nephrolithotomy and cystolithopaxy?: an in vitro study. Int Braz J Urol. 2013;39(4):579-86.
Marchini, G. S., Rai, A., De, S., Sarkissian, C., & Monga, M. (2013). Does stone entrapment with ″Uro-Net″ improve Ho:YAG laser lithotripsy efficiency in percutaneous nephrolithotomy and cystolithopaxy?: an in vitro study. International Braz J Urol : Official Journal of the Brazilian Society of Urology, 39(4), 579-86. https://doi.org/10.1590/S1677-5538.IBJU.2013.04.17
Marchini GS, et al. Does Stone Entrapment With ″Uro-Net″ Improve Ho:YAG Laser Lithotripsy Efficiency in Percutaneous Nephrolithotomy and Cystolithopaxy?: an in Vitro Study. Int Braz J Urol. 2013 Jul-Aug;39(4):579-86. PubMed PMID: 24054387.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does stone entrapment with ″Uro-Net″ improve Ho:YAG laser lithotripsy efficiency in percutaneous nephrolithotomy and cystolithopaxy?: an in vitro study. AU - Marchini,Giovanni Scala, AU - Rai,Aayushi, AU - De,Shubha, AU - Sarkissian,Carl, AU - Monga,Manoj, PY - 2012/12/10/received PY - 2013/07/02/accepted PY - 2013/9/24/entrez PY - 2013/9/24/pubmed PY - 2014/1/25/medline SP - 579 EP - 86 JF - International braz j urol : official journal of the Brazilian Society of Urology JO - Int Braz J Urol VL - 39 IS - 4 N2 - PURPOSE: to test the effect of stone entrapment on laser lithotripsy efficiency. MATERIALS AND METHODS: Spherical stone phantoms were created using the BegoStone® plaster. Lithotripsy of one stone (1.0 g) per test jar was performed with Ho:YAG laser (365 µm fiber; 1 minute/trial). Four laser settings were tested: I-0.8 J,8 Hz; II-0.2J,50 Hz; III-0.5 J,50 Hz; IV-1.5 J,40 Hz. Uro-Net (US Endoscopy) deployment was used in 3/9 trials. Post-treatment, stone fragments were strained though a 1mm sieve; after a 7-day drying period fragments and unfragmented stone were weighed. Uro-Net nylon mesh and wire frame resistance were tested (laser fired for 30s). All nets used were evaluated for functionality and strength (compared to 10 new nets). Student's T test was used to compare the studied parameters; significance was set at p < 0.05. RESULTS: Laser settings I and II caused less damage to the net overall; the mesh and wire frame had worst injuries with setting IV; setting III had an intermediate outcome; 42% of nets were rendered unusable and excluded from strength analysis. There was no difference in mean strength between used functional nets and non-used devices (8.05 vs. 7.45 lbs, respectively; p = 0.14). Setting IV was the most efficient for lithotripsy (1.9 ± 0.6 mg/s; p < 0.001) with or without net stabilization; setting III was superior to I and II only if a net was not used. CONCLUSIONS: Laser lithotripsy is not optimized by stone entrapment with a net retrieval device which may be damaged by high energy laser settings. SN - 1677-6119 UR - https://www.unboundmedicine.com/medline/citation/24054387/Does_stone_entrapment_with_″Uro_Net″_improve_Ho:YAG_laser_lithotripsy_efficiency_in_percutaneous_nephrolithotomy_and_cystolithopaxy:_an_in_vitro_study_ L2 - http://brazjurol.com.br/july_august_2013/Marchini_579_586.htm DB - PRIME DP - Unbound Medicine ER -