Comparison of the effects of Ho: YAG laser virtual Basket™ pulse modulation and Thulium fiber laser on kidney tissue - an ex vivo experimental study.

Abstract

Through an ex vivo experimental study, we aimed to compare the effects of the Ho: YAG laser Virtual Basket (VB™) modulation and a Thulium fiber laser (TFL) on kidney tissue in different environments and using laser configurations. The 100W Ho: YAG (Cyber Ho, Quanta System, Italy) and 60W TFL (Fiber Dust, Quanta System, Italy) laser devices were used. The following laser settings were selected: power in the range of 10-60W, frequency of 20-40Hz, and energy of 0.5-1-1.5J. A medium pulse duration of 600 µsec was used for VB™, while short (spdTFL; 50 µsec) and long (lpdTFL; 15,000 µsec) were used for TFL. The tissue's incision depth (ID), vaporization area (VA), coagulation area (CA), total laser area (TLA = VA + CA), surface section (SS), and lateral effect (LE) were measured. In total, 108 experiments were conducted. No statistically significant difference in mean VA, TLA, ID, LE, or SS was observed between VB™, spdTFL, and lpdTFL in the low-power output group in saline (p > 0.05). However, the mean CA was statistically significantly higher for VB™ (p = 0.005). In saline and high-power output group, the mean VA, CA, TLA, LE, and ID were higher when using lpdTFL than other pulse durations (p = 0.001, p = 0.001, p = 0.001, p = 0.006, and p = 0.001, respectively). Similar to lpdTFL, VB™ may provide controlled dissection and incision as well as haemostasis. At different laser settings, the individual effects of laser properties (such as pulse length, energy and frequency) on tissue may be more significant.