MP65-03 DOES THE NOVEL THULIUM LASER GENERATE MORE HEAT THAN THE CONVENTIONAL HOLMIUM LASER?

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy V (MP65)1 Sep 2021MP65-03 DOES THE NOVEL THULIUM LASER GENERATE MORE HEAT THAN THE CONVENTIONAL HOLMIUM LASER? Joshua D. Belle, Nathaniel Srikureja, Natalie Chen, Mohamed Keheila, Akin S. Amasyali, Jenna Lee, Mohammad Hajiha, and D. Duane Baldwin Joshua D. BelleJoshua D. Belle More articles by this author , Nathaniel SrikurejaNathaniel Srikureja More articles by this author , Natalie ChenNatalie Chen More articles by this author , Mohamed KeheilaMohamed Keheila More articles by this author , Akin S. AmasyaliAkin S. Amasyali More articles by this author , Jenna LeeJenna Lee More articles by this author , Mohammad HajihaMohammad Hajiha More articles by this author , and D. Duane BaldwinD. Duane Baldwin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002105.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The novel thulium fiber laser (TFL) has been shown to break stones more rapidly than the traditional holmium:YAG laser (HL). However, some evidence suggests that the TFL may generate comparatively more heat. The purpose of this study is to compare ureteral temperatures generated by these lasers during flexible ureteroscopic laser lithotripsy in a benchtop model. METHODS: A 1-cm BegoStone (CaOx monohydrate consistency) was manually impacted in the proximal ureter of a 3D printed kidney-ureter model and submerged in 35°C saline. Lithotripsy was performed with a flexible ureteroscope and a 200 μm laser fiber without a ureteral access sheath. Three lasers were compared (Dornier 30W HL, Olympus 100W HL, and Olympus 60W TFL). A needle thermocouple to measure temperature was inserted 2 mm from the laser tip. Irrigation was maintained at 35cc/min at room temperature using the Thermedx FluidSmart System. Intraluminal temperature was continuously recorded for 60 seconds of laser activation. Time was given between each trial for the intraureteral fluid to return to room temperature. 5 trials were performed for each of 4 different power settings: 3.6, 10, 20, and 30 Watts. ANOVA and Mann-Whitney U tests were performed, with p<0.05 considered significant. RESULTS: Intraureteral fluid temperature increased as laser power settings increased for all lasers trialed (p<0.05, table 1). The TFL produced significantly higher temperatures at both 3.6W (26.36°C vs. 24.57°C (Dornier) and 23.23°C (Empower); p<0.05) and 30W (41.76°C vs. 37.28°C (Empower); p<0.05). There was no difference in intraureteral temperature between lasers at the 10W and 20W settings. At 30W, the TFL generated supraphysiologic intraluminal temperature. CONCLUSIONS: The TFL generated significantly more heat at both the 3.6W and 30W settings. Supraphysiologic ureteral temperatures may be generated by the TFL with extended use at high energy settings and low irrigation rates. Understanding the heat generation properties of both the Holmium and Thulium lasers during ureteroscopy could help improve the safety of ureteroscopic laser lithotripsy. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1119-e1119 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua D. Belle More articles by this author Nathaniel Srikureja More articles by this author Natalie Chen More articles by this author Mohamed Keheila More articles by this author Akin S. Amasyali More articles by this author Jenna Lee More articles by this author Mohammad Hajiha More articles by this author D. Duane Baldwin More articles by this author Expand All Advertisement Loading ...