PI-05 ULTRA-SHORT, SHORT, MEDIUM AND LONG-PULSE LASER LITHOTRIPSY PERFORMANCE

Abstract

You have accessJournal of UrologyBest Abstract1 Apr 2016PI-05 ULTRA-SHORT, SHORT, MEDIUM AND LONG-PULSE LASER LITHOTRIPSY PERFORMANCE Peter Kronenberg and Olivier Traxer Peter KronenbergPeter Kronenberg More articles by this author and Olivier TraxerOlivier Traxer More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1210AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent laser lithotripter models allow the user to choose between long-pulse and short-pulse mode. However, the latest lithotripter models offer additional pulse lengths, i.e. additional pulse widths or pulse durations, ranging from the traditional short-pulse mode, to long-, medium-, and ultra-short-pulse modes. The authors decided to evaluate how the variations of these new pulse-length modes affect lithotripsy performance in comparison to traditional short-pulse lithotripsy. METHODS An automated laser fragmentation testing system was used to perform laser-lithotripsy experiments creating ablation fissures on artificial stones made from different stone material (plaster of Paris and BegoStone®). Brand-new 273-µm core laser fibers (SureFlex® 273 from AMS), cleaved with metal scissors, were employed together with a novel lithotripter (StoneLight 30 from AMS) set at 10Hz × 1.0J, capable of ultra-short- (150 µs), short- (300 µs), medium- (600 µs) and long-pulse (800 µs) lithotripsy. All combinations were tested in multiple 30-second-long lithotripsy experiments. Ablation volumes were measured, compared, and statistically analyzed. RESULTS All pulse lengths differed from each other significantly (p<0.00001), with shorter pulse lengths always outperforming the longer ones regarding ablation volume. A negative linear relation was confirmed between pulse length and ablation volume, i.e. as pulse length rises, ablation volume decreases (p<0.00001). Extreme pulse lengths comparisons (150 µs vs 800 µs) showed an average 60.6% higher ablation volume difference favoring ultra-short-pulse mode (p<0.00001). Intermediary comparisons (150 µs vs 300 µs, 300 µs vs 600 µs, and 600 µs vs 800 µs) revealed also significant differences with 12.0%, 21.6%, and 18.8% higher ablation volumes, respectively (p<0.001 for all), regardless of stone material. Ultra-short pulse mode makes 64.7% wider fissures (up to 85.9%; p<0.00001) in comparison to long-pulse mode, and although the latter creates on average 9.8% deeper fissures it isn't statistically significant (p=0.15). CONCLUSIONS Pulse length is inversely correlated with ablation volume. Traditional short-pulse lithotripter settings remain one of the more ablative settings, being only slightly out-performed by ultra-short-pulse mode. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e410 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Peter Kronenberg More articles by this author Olivier Traxer More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...