Temperature changes during irradiation of Ho:YAG laser lithotripsy in an in vitro urinary bladder model

Introduction: The holmium:yttrium-aluminum-garnet (Ho:YAG) laser is the gold standard for intracorporeal lithotripsy. Preclinical reports suggest the thulium laser fibre (TFL) may possess advantages over the Ho:YAG laser, including improved lithotripsy efficacy, enhanced safety, and lower costs. Although the TFL is well-characterized in vitro, there are no reviews examining TFL lithotripsy in a clinical setting. Methods: A review of the literature was conducted using a systematic search of MEDLINE, PubMed, and Embase, yielding a total of 130 manuscripts published up to May 2020. Two independent reviewers selected studies for screening, eligibility, and inclusion into the scoping review. Following the title, abstract, and full-text review, 14 articles were analyzed. Results: Within these articles, there were 13 prospective cohort studies and one case series. The average sample size was 100 participants. Study followup durations ranged from four weeks to three months. TFL had comparable stone-free rates to Ho:YAG lasers and improved operating time. TFL was subjectively favorable in terms of stone retropulsion, stone fragmentation, endoscopic maneuverability, and endoscopic visibility. TFL appeared clinically safe and did not result in any major complications. Many studies were underpowered and non-peer-reviewed, demonstrating the need for additional research in this field. Conclusions: The TFL has the potential to catalyze a paradigm shift in laser lithotripsy. While the objective of this scoping review was to describe the contemporary landscape of the literature, it is important to consider that inferences posed by the studies described herein must be tempered by the low quality of available evidence.

Download Full-text

In-vitro and in-vivo new evidence for Flexor® Vue™ deflecting endoscopic system use: optimization of the stone free rate (SFR) after flexible ureteroscopy and Ho:YAG laser lithotripsy

Urolithiasis ◽

10.1007/s00240-020-01215-5 ◽

2020 ◽

Author(s):

Alberto Saita ◽

Luca Villa ◽

Francesco Persico ◽

Giovanni Lughezzani ◽

Domenico Prezioso ◽

...

Keyword(s):

Laser Lithotripsy ◽

Flexible Ureteroscopy ◽

Ho:Yag Laser ◽

Stone Free Rate ◽

System Use ◽

New Evidence ◽

Free Rate

Download Full-text

Laser Fiber Displacement Velocity during Tm-Fiber and Ho:YAG Laser Lithotripsy: Introducing the Concept of Optimal Displacement Velocity

Journal of Clinical Medicine ◽

10.3390/jcm11010181 ◽

2021 ◽

Vol 11 (1) ◽

pp. 181

Author(s):

Frederic Panthier ◽

Thibault Germain ◽

Cyril Gorny ◽

Laurent Berthe ◽

Steeve Doizi ◽

...

Keyword(s):

Operation Time ◽

In Vitro Study ◽

Laser Lithotripsy ◽

Displacement Velocity ◽

Laser Source ◽

Flexible Ureteroscopy ◽

Core Diameter ◽

Ho:Yag Laser ◽

Laser Fiber

Background: Endocorporeal laser lithotripsy (EL) during flexible ureteroscopy (URS-f) often uses “dusting” settings with “painting” technique. The displacement velocity of the laser fiber (LF) at the stone surface remains unknown and could improve EL’s ablation rates. This in vitro study aimed to define the optimal displacement velocity (ODV) for both holmium:yttrium-aluminium-garnet (Ho:YAG) and thulium fiber laser (Tm-Fiber). Methods: A 50W-TFL (IRE Polus®, Russia) and a 30W-MH1-Ho:YAG laser (Rocamed®), were used with 272µm-Core-Diameter LF (Sureflex, Boston Scientific©), comparing three TFL modes, “fine dusting” (FD:0.05–0.15 J/100–600 Hz); “dusting” (D:0.5 J/30–60 Hz); “fragmentation” (Fr:1 J/15–30 Hz) and two Ho:YAG modes (D:0.5 J/20 Hz, Fr:1 J/15 Hz). An experimental setup consisting of immerged cubes of calcium oxalate monohydrate (COM) stone phantoms (Begostone Plus, Begoã) was used with a 2 seconds’ laser operation time. LF were in contact with the stones, static or with a displacement of 5, 10 or 20 mm. Experiments were repeated four times. Stones were dried and µ-scanned. Ablation volumes (mm3) were measured by 3D-segmentation. Results: ODV was higher in dusting compared to fragmentation mode during Ho:YAG lithotripsy (10 mm/sec vs. 5 mm/sec, respectively). With Tm-Fiber, dusting and fragmentation OVDs were similar (5 mm/sec). Tm-Fiber ODV was lower than Ho:YAGs in dusting settings (5 mm/s vs. 10 mm/sec, respectively). Without LF displacement, ablation volumes were at least two-fold higher with Tm-Fiber compared to Ho:YAG. Despite the LF-DV, we report a 1.5 to 5-fold higher ablation volume with Tm-Fiber compared to Ho:YAG. Conclusions: In dusting mode, the ODVTm-Fiber is lower compared to ODVHo:YAG, translating to a potential easier Tm-Fiber utilization for “painting” dusting technique. The ODV determinants remain unknown. Dynamic ablation volumes are higher to static ones, regardless of the laser source, settings or LF displacement velocity.

Download Full-text

In-vitro assessment of Ho:YAG laser lithotripsy for the treatment of canine urolithiasis

10.1117/12.437913 ◽

2002 ◽

Cited By ~ 1

Author(s):

Victoria Wynn ◽

Ellen Davidson ◽

Russell G. Higbee ◽

Jerry W. Ritchey ◽

Tisha Ridgway ◽

...

Keyword(s):

Laser Lithotripsy ◽

Ho:Yag Laser ◽

In Vitro Assessment

Download Full-text

Does Stone Entrapment With "Uro-Net" Improve Ho:YAG Laser Lithotripsy Efficiency in Percutaneous Nephrolithotomy and Cystolithopaxy?: an In Vitro Study

International braz j urol ◽

10.1590/s1677-5538.ibju.2013.04.17 ◽

2013 ◽

Vol 39 (4) ◽

pp. 579-586

Author(s):

Giovanni Scala Marchini ◽

Aayushi Rai ◽

Shubha De ◽

Carl Sarkissian ◽

Manoj Monga

Keyword(s):

Percutaneous Nephrolithotomy ◽

In Vitro Study ◽

Laser Lithotripsy ◽

Vitro Study ◽

Ho:Yag Laser

Download Full-text

OSMOTIC INHIBITION OF THE NATRIFERIC RESPONSE OF THE TOAD URINARY BLADDER TO VASOPRESSIN

Journal of Endocrinology ◽

10.1677/joe.0.0670119 ◽

1975 ◽

Vol 67 (1) ◽

pp. 119-125

Author(s):

P. J. BENTLEY

Keyword(s):

Urinary Bladder ◽

Water Movement ◽

Short Circuit ◽

Electrical Potential ◽

Short Circuit Current ◽

Toad Bladder ◽

Toad Urinary Bladder ◽

Electrical Potential Difference ◽

Osmotic Gradient

SUMMARY The electrical potential difference and short-circuit current (scc, reflecting active transmural sodium transport) across the toad urinary bladder in vitro was unaffected by the presence of hypo-osmotic solutions bathing the mucosal (urinary) surface, providing that the transmural flow of water was small. Vasopressin increased the scc across the toad bladder (the natriferic response), but this stimulation was considerably reduced in the presence of a hypo-osmotic solution on the mucosal side, conditions under which water transfer across the membrane was also increased. This inhibition of the natriferic response did not depend on the direction of the water movement, for if the osmotic gradient was the opposite way to that which normally occurs, the response to vasopressin was still reduced. The natriferic response to cyclic AMP was also inhibited in the presence of an osmotic gradient. Aldosterone increased the scc and Na+ transport across the toad bladder but this response was not changed when an osmotic gradient was present. The physiological implications of these observations and the possible mechanisms involved are discussed.

Download Full-text