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Safety of a Novel Thulium Fiber Laser for Lithotripsy: An In Vitro Study on the Thermal Effect and Its Impact Factor.
J Endourol. 2020 01; 34(1):88-92.JE

Abstract

Introduction: To investigate the thermal effect on the water by a novel thulium fiber laser (TFL) designed for lithotripsy and evaluate the safety of this laser for clinical use. Materials and

Methods:

An in vitro experimental setup was constructed. A test tube filled with saline was immersed in an electric water bath, and a TFL fiber and a thermal probe were inserted into it. Saline was irrigated into the tube and pumped out synchronously at the same speed by two pumps, respectively, to maintain convection when needed. Then, continuous TFL firing of different power settings was imposed to saline in the tube for 60 seconds, on the conditions of different irrigation rates. The temperature was recorded every 5 seconds during the whole trial, and each trial was repeated five times. Safety threshold of temperature increase (STTI) was determined comparing with the deemed safe temperature of 43°C in vivo.

Results:

On condition of 0 mL/min irrigation rate, STTI was 6.5°C, and water temperature increase (WTI) caused by ≥15 W settings surpassed STTI after 20 seconds of laser firing; on condition of 15 mL/min irrigation rate, only WTI caused by the highest 30 W power setting surpassed STTI after 45 seconds of laser firing. When irrigation rate was added up to 25 and 50 mL/min, WTIs caused by all power settings were below STTIs in a 60-second experiment. High frequency and low pulse energy combinations caused a slightly higher WTI compared with low frequency and high pulse energy, given a constant power and irrigation rate.

Conclusion:

Power setting and irrigation rate collaboratively play a critical role in WTI during TFL lithotripsy, and it is safe to use TFL referring to the thermal effect as long as there is moderate irrigation, while TFL power should be lowered enough when irrigation is ceased.

Authors+Show Affiliations

Department of Urology, Shanghai Changhai Hospital, Shanghai, China.Department of Urology, Shanghai Changhai Hospital, Shanghai, China.Department of Urology, Shanghai Changhai Hospital, Shanghai, China.Department of Urology, Shaoxing Shangyu People's Hospital, Zhejiang, China.Department of Urology, Shanghai Changhai Hospital, Shanghai, China.Department of Urology, Shanghai Changhai Hospital, Shanghai, China.Department of Urology, Shanghai Changhai Hospital, Shanghai, China.Department of Urology, Shanghai Changhai Hospital, Shanghai, China.Department of Urology, Shanghai Changhai Hospital, Shanghai, China.Department of Urology, Shanghai Changhai Hospital, Shanghai, China.Department of Urology, Shanghai Changhai Hospital, Shanghai, China.Department of Urology, Shanghai Changhai Hospital, Shanghai, China.Department of Urology, Shanghai Changhai Hospital, Shanghai, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31608659

Citation

Peng, Yonghan, et al. "Safety of a Novel Thulium Fiber Laser for Lithotripsy: an in Vitro Study On the Thermal Effect and Its Impact Factor." Journal of Endourology, vol. 34, no. 1, 2020, pp. 88-92.
Peng Y, Liu M, Ming S, et al. Safety of a Novel Thulium Fiber Laser for Lithotripsy: An In Vitro Study on the Thermal Effect and Its Impact Factor. J Endourol. 2020;34(1):88-92.
Peng, Y., Liu, M., Ming, S., Yu, W., Li, L., Lu, C., Fang, Z., Wang, Z., Dong, H., Shen, R., Xie, F., Gao, X., & Gao, X. (2020). Safety of a Novel Thulium Fiber Laser for Lithotripsy: An In Vitro Study on the Thermal Effect and Its Impact Factor. Journal of Endourology, 34(1), 88-92. https://doi.org/10.1089/end.2019.0426
Peng Y, et al. Safety of a Novel Thulium Fiber Laser for Lithotripsy: an in Vitro Study On the Thermal Effect and Its Impact Factor. J Endourol. 2020;34(1):88-92. PubMed PMID: 31608659.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety of a Novel Thulium Fiber Laser for Lithotripsy: An In Vitro Study on the Thermal Effect and Its Impact Factor. AU - Peng,Yonghan, AU - Liu,Min, AU - Ming,Shaoxiong, AU - Yu,Weixing, AU - Li,Ling, AU - Lu,Chaoyue, AU - Fang,Ziyu, AU - Wang,Zeyu, AU - Dong,Hao, AU - Shen,Rong, AU - Xie,Fei, AU - Gao,Xiaomin, AU - Gao,Xiaofeng, Y1 - 2019/12/20/ PY - 2019/10/15/pubmed PY - 2019/10/15/medline PY - 2019/10/15/entrez KW - thermal effect KW - thulium fiber laser KW - ureteroscopic lithotripsy KW - water temperature increase SP - 88 EP - 92 JF - Journal of endourology JO - J. Endourol. VL - 34 IS - 1 N2 - Introduction: To investigate the thermal effect on the water by a novel thulium fiber laser (TFL) designed for lithotripsy and evaluate the safety of this laser for clinical use. Materials and Methods: An in vitro experimental setup was constructed. A test tube filled with saline was immersed in an electric water bath, and a TFL fiber and a thermal probe were inserted into it. Saline was irrigated into the tube and pumped out synchronously at the same speed by two pumps, respectively, to maintain convection when needed. Then, continuous TFL firing of different power settings was imposed to saline in the tube for 60 seconds, on the conditions of different irrigation rates. The temperature was recorded every 5 seconds during the whole trial, and each trial was repeated five times. Safety threshold of temperature increase (STTI) was determined comparing with the deemed safe temperature of 43°C in vivo. Results: On condition of 0 mL/min irrigation rate, STTI was 6.5°C, and water temperature increase (WTI) caused by ≥15 W settings surpassed STTI after 20 seconds of laser firing; on condition of 15 mL/min irrigation rate, only WTI caused by the highest 30 W power setting surpassed STTI after 45 seconds of laser firing. When irrigation rate was added up to 25 and 50 mL/min, WTIs caused by all power settings were below STTIs in a 60-second experiment. High frequency and low pulse energy combinations caused a slightly higher WTI compared with low frequency and high pulse energy, given a constant power and irrigation rate. Conclusion: Power setting and irrigation rate collaboratively play a critical role in WTI during TFL lithotripsy, and it is safe to use TFL referring to the thermal effect as long as there is moderate irrigation, while TFL power should be lowered enough when irrigation is ceased. SN - 1557-900X UR - https://www.unboundmedicine.com/medline/citation/31608659/Safety_of_a_Novel_Thulium_Fiber_Laser_for_Lithotripsy:_An_In_Vitro_Study_on_the_Thermal_Effect_and_Its_Impact_Factor_ L2 - https://www.liebertpub.com/doi/10.1089/end.2019.0426?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
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