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Use of the Moses Technology to Improve Holmium Laser Lithotripsy Outcomes: A Preclinical Study.
J Endourol 2017; 31(6):598-604JE

Abstract

OBJECTIVE

To evaluate in vitro and in vivo effects of Moses technology in Holmium laser and to compare it with the Regular mode in terms of lithotripsy efficiency and laser-tissue interactions.

METHODS

The Lumenis® Pulse™ P120H holmium laser system together with Moses D/F/L fibers were used to compare the Regular mode with the Moses modes in stone retropulsion by using a high-speed camera, and stone ablation efficiency. In addition, a porcine ureteroscopy model was used to assess stone fragmentation and dusting as well as laser-tissue interaction with the ureteral wall.

RESULTS

After a laser pulse, in vitro stone displacement experiments showed a significant reduction in retropulsion when using the Moses mode. The stone movement was reduced by 50 times at 0.8 J and 10 Hz (p < 0.01). The pronounced reduction of retropulsion in the Moses mode was clearly observed during fragmentation setting (high energy) and dusting (low energy, high Hz). In addition, stone fragmentation tests showed that the Moses modes resulted in a significantly higher ablation volume when compared with the Regular mode (160% higher; p < 0.001). In vivo assessment also supported the reduction in retropulsion when treating stones in the porcine kidney. Histological analysis of the porcine ureter after direct lasing in the Moses mode suggested less damage than in the Regular mode.

CONCLUSIONS

The Moses technology resulted in more efficient laser lithotripsy, in addition to significantly reduced stone retropulsion, and displayed a margin of safety that may result in a shorter procedural time and safer lithotripsy.

Authors+Show Affiliations

1 Department of Urology, Royal Victoria Hospital, McGill University Health Centre , Montreal, Canada .2 Department of Urology, Rambam Health Care Campus , Haifa, Israel .1 Department of Urology, Royal Victoria Hospital, McGill University Health Centre , Montreal, Canada . 3 Department of Urology, Alhussain University Hospital, Al-Azhar University , Cairo, Egypt .1 Department of Urology, Royal Victoria Hospital, McGill University Health Centre , Montreal, Canada .

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

28340540

Citation

Elhilali, Mostafa M., et al. "Use of the Moses Technology to Improve Holmium Laser Lithotripsy Outcomes: a Preclinical Study." Journal of Endourology, vol. 31, no. 6, 2017, pp. 598-604.
Elhilali MM, Badaan S, Ibrahim A, et al. Use of the Moses Technology to Improve Holmium Laser Lithotripsy Outcomes: A Preclinical Study. J Endourol. 2017;31(6):598-604.
Elhilali, M. M., Badaan, S., Ibrahim, A., & Andonian, S. (2017). Use of the Moses Technology to Improve Holmium Laser Lithotripsy Outcomes: A Preclinical Study. Journal of Endourology, 31(6), pp. 598-604. doi:10.1089/end.2017.0050.
Elhilali MM, et al. Use of the Moses Technology to Improve Holmium Laser Lithotripsy Outcomes: a Preclinical Study. J Endourol. 2017;31(6):598-604. PubMed PMID: 28340540.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of the Moses Technology to Improve Holmium Laser Lithotripsy Outcomes: A Preclinical Study. AU - Elhilali,Mostafa M, AU - Badaan,Shadie, AU - Ibrahim,Ahmed, AU - Andonian,Sero, Y1 - 2017/04/25/ PY - 2017/3/28/pubmed PY - 2018/2/13/medline PY - 2017/3/26/entrez KW - Holmium-YAG laser KW - laser lithotripsy KW - preclinical evaluation KW - prospective study SP - 598 EP - 604 JF - Journal of endourology JO - J. Endourol. VL - 31 IS - 6 N2 - OBJECTIVE: To evaluate in vitro and in vivo effects of Moses technology in Holmium laser and to compare it with the Regular mode in terms of lithotripsy efficiency and laser-tissue interactions. METHODS: The Lumenis® Pulse™ P120H holmium laser system together with Moses D/F/L fibers were used to compare the Regular mode with the Moses modes in stone retropulsion by using a high-speed camera, and stone ablation efficiency. In addition, a porcine ureteroscopy model was used to assess stone fragmentation and dusting as well as laser-tissue interaction with the ureteral wall. RESULTS: After a laser pulse, in vitro stone displacement experiments showed a significant reduction in retropulsion when using the Moses mode. The stone movement was reduced by 50 times at 0.8 J and 10 Hz (p < 0.01). The pronounced reduction of retropulsion in the Moses mode was clearly observed during fragmentation setting (high energy) and dusting (low energy, high Hz). In addition, stone fragmentation tests showed that the Moses modes resulted in a significantly higher ablation volume when compared with the Regular mode (160% higher; p < 0.001). In vivo assessment also supported the reduction in retropulsion when treating stones in the porcine kidney. Histological analysis of the porcine ureter after direct lasing in the Moses mode suggested less damage than in the Regular mode. CONCLUSIONS: The Moses technology resulted in more efficient laser lithotripsy, in addition to significantly reduced stone retropulsion, and displayed a margin of safety that may result in a shorter procedural time and safer lithotripsy. SN - 1557-900X UR - https://www.unboundmedicine.com/medline/citation/28340540/Use_of_the_Moses_Technology_to_Improve_Holmium_Laser_Lithotripsy_Outcomes:_A_Preclinical_Study_ L2 - https://www.liebertpub.com/doi/full/10.1089/end.2017.0050?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -