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Preclinical comparison of superpulse thulium fiber laser and a holmium:YAG laser for lithotripsy.
World J Urol. 2020 Feb; 38(2):497-503.WJ

Abstract

PURPOSE

A superpulse (500 W peak power) thulium fiber laser operating at a 1940 nm wavelength, suitable for lithotripsy, has recently been developed. The goal of this study was to compare stone fragmentation and dusting performance of the prototype superpulse thulium fiber laser with leading commercially available, high-power holmium:YAG lithotripters (wavelength 2100 nm) in a controlled in vitro environment.

METHODS

Two experimental setups were designed for investigating stone ablation rates and retropulsion effects, respectively. In addition, the ablation setup enabled water temperature measurements during stone fragmentation in the laser-stone interaction zone. Human uric acid (UA) and calcium oxalate monohydrate (COM) stones were used for ablation experiments, whereas standard BegoStone phantoms were utilized in retropulsion experiments. The laser settings were matched in terms of pulse energy, pulse repetition rate, and average power.

RESULTS

At equivalent settings, thulium fiber laser ablation rates were higher than those for holmium:YAG laser in both dusting mode (threefold for COM stones and 2.5-fold for UA stones) and fragmentation mode (twofold for UA stones). For single-pulse retropulsion experiments, the threshold for onset of stone retropulsion was two to four times higher for thulium fiber laser. The holmium:YAG laser generated significantly stronger retropulsion effects at equal pulse energies. The water temperature elevation near the laser-illuminated volume did not differ between the two lasers.

CONCLUSIONS

Distinctive features of the thulium fiber laser (optimal wavelength and long pulse duration) resulted in faster stone ablation and lower retropulsion in comparison to the holmium:YAG laser.

Authors+Show Affiliations

NTO "IRE-POLUS", One Vvedenskogo Sq, Fryazino, Moscow Region, 141120, Russia.Institute for Urology and Reproductive Health, Sechenov University, 19 Bolshaya Pirogovskaya Ul, Moscow, 119146, Russia.IPG Medical, 377 Simarano Dr, Marlborough, MA, 01752, USA. iyaroslavsky@ipgmedical.com.NTO "IRE-POLUS", One Vvedenskogo Sq, Fryazino, Moscow Region, 141120, Russia.IPG Medical, 377 Simarano Dr, Marlborough, MA, 01752, USA.Institute for Urology and Reproductive Health, Sechenov University, 19 Bolshaya Pirogovskaya Ul, Moscow, 119146, Russia.Institute for Urology and Reproductive Health, Sechenov University, 19 Bolshaya Pirogovskaya Ul, Moscow, 119146, Russia.Institute for Urology and Reproductive Health, Sechenov University, 19 Bolshaya Pirogovskaya Ul, Moscow, 119146, Russia.Institute for Urology and Reproductive Health, Sechenov University, 19 Bolshaya Pirogovskaya Ul, Moscow, 119146, Russia.Institute for Urology and Reproductive Health, Sechenov University, 19 Bolshaya Pirogovskaya Ul, Moscow, 119146, Russia.Institute for Urology and Reproductive Health, Sechenov University, 19 Bolshaya Pirogovskaya Ul, Moscow, 119146, Russia.Department of Physics and Optical Science, University of North Carolina Charlotte, 9201 University City Boulevard, Charlotte, NC, 28223, USA.University Pierre et Marie Curie Paris VI, 4 Place Jussieu, 75005, Paris, France.IPG Medical, 377 Simarano Dr, Marlborough, MA, 01752, USA.IPG Photonics, 50 Old Webster Rd, Oxford, MA, 01540, USA.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

31055626

Citation

Andreeva, Viktoria, et al. "Preclinical Comparison of Superpulse Thulium Fiber Laser and a holmium:YAG Laser for Lithotripsy." World Journal of Urology, vol. 38, no. 2, 2020, pp. 497-503.
Andreeva V, Vinarov A, Yaroslavsky I, et al. Preclinical comparison of superpulse thulium fiber laser and a holmium:YAG laser for lithotripsy. World J Urol. 2020;38(2):497-503.
Andreeva, V., Vinarov, A., Yaroslavsky, I., Kovalenko, A., Vybornov, A., Rapoport, L., Enikeev, D., Sorokin, N., Dymov, A., Tsarichenko, D., Glybochko, P., Fried, N., Traxer, O., Altshuler, G., & Gapontsev, V. (2020). Preclinical comparison of superpulse thulium fiber laser and a holmium:YAG laser for lithotripsy. World Journal of Urology, 38(2), 497-503. https://doi.org/10.1007/s00345-019-02785-9
Andreeva V, et al. Preclinical Comparison of Superpulse Thulium Fiber Laser and a holmium:YAG Laser for Lithotripsy. World J Urol. 2020;38(2):497-503. PubMed PMID: 31055626.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preclinical comparison of superpulse thulium fiber laser and a holmium:YAG laser for lithotripsy. AU - Andreeva,Viktoria, AU - Vinarov,Andrey, AU - Yaroslavsky,Ilya, AU - Kovalenko,Anastasia, AU - Vybornov,Alexander, AU - Rapoport,Leonid, AU - Enikeev,Dmitry, AU - Sorokin,Nikolay, AU - Dymov,Alim, AU - Tsarichenko,Dmitry, AU - Glybochko,Petr, AU - Fried,Nathaniel, AU - Traxer,Olivier, AU - Altshuler,Gregory, AU - Gapontsev,Valentin, Y1 - 2019/05/04/ PY - 2019/02/15/received PY - 2019/04/25/accepted PY - 2019/5/6/pubmed PY - 2019/5/6/medline PY - 2019/5/6/entrez KW - Holmium:YAG laser KW - Lithotripsy KW - Thulium fiber laser SP - 497 EP - 503 JF - World journal of urology JO - World J Urol VL - 38 IS - 2 N2 - PURPOSE: A superpulse (500 W peak power) thulium fiber laser operating at a 1940 nm wavelength, suitable for lithotripsy, has recently been developed. The goal of this study was to compare stone fragmentation and dusting performance of the prototype superpulse thulium fiber laser with leading commercially available, high-power holmium:YAG lithotripters (wavelength 2100 nm) in a controlled in vitro environment. METHODS: Two experimental setups were designed for investigating stone ablation rates and retropulsion effects, respectively. In addition, the ablation setup enabled water temperature measurements during stone fragmentation in the laser-stone interaction zone. Human uric acid (UA) and calcium oxalate monohydrate (COM) stones were used for ablation experiments, whereas standard BegoStone phantoms were utilized in retropulsion experiments. The laser settings were matched in terms of pulse energy, pulse repetition rate, and average power. RESULTS: At equivalent settings, thulium fiber laser ablation rates were higher than those for holmium:YAG laser in both dusting mode (threefold for COM stones and 2.5-fold for UA stones) and fragmentation mode (twofold for UA stones). For single-pulse retropulsion experiments, the threshold for onset of stone retropulsion was two to four times higher for thulium fiber laser. The holmium:YAG laser generated significantly stronger retropulsion effects at equal pulse energies. The water temperature elevation near the laser-illuminated volume did not differ between the two lasers. CONCLUSIONS: Distinctive features of the thulium fiber laser (optimal wavelength and long pulse duration) resulted in faster stone ablation and lower retropulsion in comparison to the holmium:YAG laser. SN - 1433-8726 UR - https://www.unboundmedicine.com/medline/citation/31055626/Preclinical_comparison_of_superpulse_thulium_fiber_laser_and_a_holmium:YAG_laser_for_lithotripsy_ L2 - https://dx.doi.org/10.1007/s00345-019-02785-9 DB - PRIME DP - Unbound Medicine ER -