Histopathological effects of laser fiber diameter in different laser modulations: an experimental exvivo study

Abstract

We aimed to compare the histopathological effects of different laser fiber diameters on kidney tissue using different modulations of holmium laser. An ex vivo trial was performed employing veal kidneys. A 100 W HoYAG laser device (Cyber Ho, Quanta System, Samarate, Italy) was employed, accompanied by 550 μm and 272 μm laser fibers for all experimental procedures. Incision depth (ID), vaporization area (VA), coagulation area (CA), surface section (SS), lateral effect (LE) and total laser area (TLA, calculated as VA+CA) were assessed. Histopathological measurement results of different laser fiber diameters were compared in Standard mode (SM) and Virtual BasketTM (VB) mode. In SM and VB, a statistically significant difference was found in the mean CA values between 272 (μm) and 550 (μm) laser diameters (p: 0.02 and p<0.001, respectively). In SM, the lowest and highest mean CAs were observed with the 272 (μm) lasers at 0.5 J-40 Hz and 1.5 J-40 Hz laser configurations (0.263±0.003 mm2 and 1.353±0.015 mm2, respectively). In VB, the lowest and highest mean CAs were observed with the 550 (μm) at 0.5 J-20 Hz and 1 J-20 Hz laser settings (0.987±0.014 mm2 and 1.969±0.029 mm2, respectively). We found that both SM and VB modulations have higher CA values, a measure of hemostasis, in 550 μm fibers compared to 272 μm fibers.