MP06-13 COMPARISON OF LASER OPERATOR DUTY CYCLES (ODC) DURING HIGH POWER HOLMIUM:YAG (HO:YAG) VERSUS THULIUM FIBER LASER (TFL) LITHOTRIPSY

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy I (MP06)1 Sep 2021MP06-13 COMPARISON OF LASER OPERATOR DUTY CYCLES (ODC) DURING HIGH POWER HOLMIUM:YAG (HO:YAG) VERSUS THULIUM FIBER LASER (TFL) LITHOTRIPSY Ahmed Ghazi, Mahmoud Khalil, Rajat Jain, and Scott Quarrier Ahmed GhaziAhmed Ghazi More articles by this author , Mahmoud KhalilMahmoud Khalil More articles by this author , Rajat JainRajat Jain More articles by this author , and Scott QuarrierScott Quarrier More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001973.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: ODC is a measure to compare efficiency of laser activation during ureteroscopy, ranging between 32% to 63% for Ho:YAG lithotripsy. Laser ODC is defined as LOT (overall time the laser pedal is depressed) divided by Lithotripsy Time (LT; first to last pedal activation including pauses). In vitro studies with TFL lithotripsy suggest decreased retropulsion and improved visualization compared to the Ho:YAG laser. These factors may directly impact LOT and pauses thus ODC. The objective of this study was to quantify if differences in retropulsion, visualization and efficiency between Ho:YAG (100W Empower, Olympus) and TFL (Soltive PLS, Olympus) lasers during ureteroscopic lithotripsy procedures. METHODS: A prospective study enrolled 62 patients (31 per group) with 10–30 mm renal calculi undergoing ureteroscopy with fixed dusting settings (0.4J X 60Hz) for both lasers by 3 endourology faculty. LOT and lithotripsy times were collected from laser logs of each case. LOT was verified by the formula (LOT= total energy delivered [J])/(energy [J] x frequency [Hz]) for any discrepancy. Retropulsion, visibility, and bleeding during lithotripsy were graded for all cases by the three urologists using 5-point Likert scales. ODC was calculated using the formula (LOT/LT). Correlation coefficients were calculated to define relationships between stone and lithotripsy characteristics. RESULTS: Mean age, BMI, stone number, density, ellipsoid stone volume and STONE score were not significantly different between the groups (Table 1). TFL was graded more favorably in retropulsion (1.6 vs 2.8), visibility (1.8 vs 3.3) and bleeding (1.1 vs 1.9) gradings. TFL lithotripsy also had significantly shorter LOTs (380.6 vs 533.6 seconds, p=0.015) and superior ODC efficiency (49.1% vs 34.2%, p=0.0001). (Table 1). An inverse correlation was found between ODC and stone density, volume and STONE score as well as retropulsion, visualization and bleeding grading. CONCLUSIONS: These findings suggest that TFL may be more efficient than Ho:YAG in the treatment of medium to large stones when operated in dusting mode. The longer pedal activation times during TFL especially at higher settings may necessitate future studies on their thermal implications. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e94-e95 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmed Ghazi More articles by this author Mahmoud Khalil More articles by this author Rajat Jain More articles by this author Scott Quarrier More articles by this author Expand All Advertisement Loading ...