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Initial Clinical Experience with a Modulated Holmium Laser Pulse-Moses Technology: Does It Enhance Laser Lithotripsy Efficacy?

Abstract

OBJECTIVE

The Lumenis® High-power Holmium Laser (120H) has a unique modulated pulse mode, Moses™ technology. Moses technology modulates the laser pulse to separate the water (vapor bubble), then deliver the remaining energy through the bubble. Proprietary laser fibers were designed for the Moses technology. Our aim was to compare stone lithotripsy with and without the Moses technology.

METHODS

We designed a questionnaire for the urologist to fill immediately after each ureteroscopy in which the Lumenis 120H was used. We compared procedures with (n=23) and without (n=11) the use of Moses technology. Surgeons ranked the Moses technology in 23 procedures, in comparison to regular lithotripsy (worse, equivalent, better, much better). Laser working time and energy use were collected from the Lumenis 120H log.

RESULTS

During 4 months, five urologists used the Lumenis 120H in 34 ureteroscopy procedures (19 kidney stones, 15 ureteral stones; 22 procedures with a flexible ureteroscope, and 12 with a semi-rigid ureteroscope). Three urologists ranked Moses technology as much better or better in 17 procedures. In 2 cases, it was ranked equivalent, and in 4 cases ranking was not done. Overall, laser lithotripsy with Moses technology utilized laser energy in less time to achieve a satisfying stone fragmentation rate of 95.8 mm3/min versus 58.1 mm3/min, P=0.19. However, this did not reach statistical significance.

CONCLUSION

The new Moses laser technology demonstrated good stone fragmentation capabilities when used in everyday clinical practice.

Authors+Show Affiliations

Department of Urology, Rambam Health Care Campus, Haifa, Israel.Department of Urology, Rambam Health Care Campus, Haifa, Israel.Department of Urology, Rambam Health Care Campus, Haifa, Israel.Department of Urology, Rambam Health Care Campus, Haifa, Israel.Department of Urology, Rambam Health Care Campus, Haifa, Israel.Department of Urology, Rambam Health Care Campus, Haifa, Israel.Department of Urology, Rambam Health Care Campus, Haifa, Israel.Department of Urology, Rambam Health Care Campus, Haifa, Israel.Department of Urology, Rambam Health Care Campus, Haifa, Israel.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28914602

Citation

Mullerad, Michael, et al. "Initial Clinical Experience With a Modulated Holmium Laser Pulse-Moses Technology: Does It Enhance Laser Lithotripsy Efficacy?" Rambam Maimonides Medical Journal, vol. 8, no. 4, 2017.
Mullerad M, Aguinaga JRA, Aro T, et al. Initial Clinical Experience with a Modulated Holmium Laser Pulse-Moses Technology: Does It Enhance Laser Lithotripsy Efficacy? Rambam Maimonides Med J. 2017;8(4).
Mullerad, M., Aguinaga, J. R. A., Aro, T., Kastin, A., Goldin, O., Kravtsov, A., ... Amiel, G. E. (2017). Initial Clinical Experience with a Modulated Holmium Laser Pulse-Moses Technology: Does It Enhance Laser Lithotripsy Efficacy? Rambam Maimonides Medical Journal, 8(4), doi:10.5041/RMMJ.10315.
Mullerad M, et al. Initial Clinical Experience With a Modulated Holmium Laser Pulse-Moses Technology: Does It Enhance Laser Lithotripsy Efficacy. Rambam Maimonides Med J. 2017 10 16;8(4) PubMed PMID: 28914602.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Initial Clinical Experience with a Modulated Holmium Laser Pulse-Moses Technology: Does It Enhance Laser Lithotripsy Efficacy? AU - Mullerad,Michael, AU - Aguinaga,Jonatan R A, AU - Aro,Tareq, AU - Kastin,Alexander, AU - Goldin,Oleg, AU - Kravtsov,Alexander, AU - Assadi,Akram, AU - Badaan,Shadie, AU - Amiel,Gilad E, Y1 - 2017/10/16/ PY - 2017/9/16/pubmed PY - 2017/9/16/medline PY - 2017/9/16/entrez JF - Rambam Maimonides medical journal JO - Rambam Maimonides Med J VL - 8 IS - 4 N2 - OBJECTIVE: The Lumenis® High-power Holmium Laser (120H) has a unique modulated pulse mode, Moses™ technology. Moses technology modulates the laser pulse to separate the water (vapor bubble), then deliver the remaining energy through the bubble. Proprietary laser fibers were designed for the Moses technology. Our aim was to compare stone lithotripsy with and without the Moses technology. METHODS: We designed a questionnaire for the urologist to fill immediately after each ureteroscopy in which the Lumenis 120H was used. We compared procedures with (n=23) and without (n=11) the use of Moses technology. Surgeons ranked the Moses technology in 23 procedures, in comparison to regular lithotripsy (worse, equivalent, better, much better). Laser working time and energy use were collected from the Lumenis 120H log. RESULTS: During 4 months, five urologists used the Lumenis 120H in 34 ureteroscopy procedures (19 kidney stones, 15 ureteral stones; 22 procedures with a flexible ureteroscope, and 12 with a semi-rigid ureteroscope). Three urologists ranked Moses technology as much better or better in 17 procedures. In 2 cases, it was ranked equivalent, and in 4 cases ranking was not done. Overall, laser lithotripsy with Moses technology utilized laser energy in less time to achieve a satisfying stone fragmentation rate of 95.8 mm3/min versus 58.1 mm3/min, P=0.19. However, this did not reach statistical significance. CONCLUSION: The new Moses laser technology demonstrated good stone fragmentation capabilities when used in everyday clinical practice. SN - 2076-9172 UR - https://www.unboundmedicine.com/medline/citation/28914602/Initial_Clinical_Experience_with_a_Modulated_Holmium_Laser_Pulse_Moses_Technology:_Does_It_Enhance_Laser_Lithotripsy_Efficacy L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/28914602/ DB - PRIME DP - Unbound Medicine ER -