PD26-07 IMAGE DISTORTION DURING FLEXIBLE URETEROSCOPY: A LABORATORY MODEL COMPARING SUPER PULSE THULIUM FIBER (SPTF) LASER VS HIGH POWER HO:YAG LASER

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy III (PD26)1 Sep 2021PD26-07 IMAGE DISTORTION DURING FLEXIBLE URETEROSCOPY: A LABORATORY MODEL COMPARING SUPER PULSE THULIUM FIBER (SPTF) LASER VS HIGH POWER HO:YAG LASER Caleb S Miller, Bristol B Whiles, David A Duchene, Donald A Neff, and Wilson R Molina Caleb S MillerCaleb S Miller More articles by this author , Bristol B WhilesBristol B Whiles More articles by this author , David A DucheneDavid A Duchene More articles by this author , Donald A NeffDonald A Neff More articles by this author , and Wilson R MolinaWilson R Molina More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002019.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Digital ureteroscopes employ “chip on the tip” technology which allows significant improvement in image resolution. However, image distortion often occurs during laser lithotripsy due to acoustic wave production. We sought to compare the Super Pulse Thulium Fiber (SPTF) laser with the high power Holmium (Ho:YAG) laser in terms of image distortion using variable laser power settings and laser fiber tip distance from the scope’s tip. METHODS: Utilizing a silicone renal model fitted with a 12/14F access sheath, we developed a laboratory model to simulate ureteroscopy. The LithoVue (Boston Scientific), disposable digital flexible ureteroscope was used with 200 micron laser fibers for both the SPTF (Soltive-Olympus) and High power Ho:YAG laser (P120-Lumenis). At defined laser parameters (10, 20, 30, and 40W; short pulse) the laser fiber was slowly retracted toward the tip of the scope during laser activation. Image distortion was identified, and distance from the laser tip to the scope tip was determined. Data from the two lasers were compared utilizing a paired t-test. RESULTS: Image distortion occurred at greater distance with the Ho:YAG compared to SPTF at all laser settings (Table 1). Additionally, higher power (W) was associated with image distortion occurring further from the tip of the scope (p<0.01 for Ho:YAG; p=0.02 for SPFT). At the same power (W) with either 1J or 0.5J, there was no difference in distance for image distortion for the Ho:YAG, but distortion occurred differently with the SPTF (20 and 40W; p<0.01 and p=0.02, respectively). CONCLUSIONS: Increased total power as well as decreased distance between the scope and laser fiber tip results in image distortion during flexible ureteroscopy. Image distortion occurs at a greater distance with the Ho:YAG laser than with SPTF fibers at the same laser settings. SPTF seems to have a better safety profile in terms image distortion and potential scope damage. Further evaluation utilizing Ho:YAG on modulated pulse mode is warranted. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e440-e440 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Caleb S Miller More articles by this author Bristol B Whiles More articles by this author David A Duchene More articles by this author Donald A Neff More articles by this author Wilson R Molina More articles by this author Expand All Advertisement Loading ...