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01.12.2024 | Original Article

How much energy do we need to ablate 1 cubic millimeter of stone during Thulium Fiber Laser lithotripsy? An in vitro study

verfasst von: Frédéric Panthier, Marie Chicaud, Steeve Doizi, Stessy Kutchukian, Pierre Lapouge, Catalina Solano, Luigi Candela, Michel Daudon, Laurent Berthe, Mariela Corrales, Olivier Traxer

Erschienen in: World Journal of Urology | Ausgabe 1/2024

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Abstract

Introduction

Both Holmium:yttrium–aluminium–garnet (Ho:YAG) laser and Thulium Fiber Laser (TFL) can effectively treat all urinary stone types. This in vitro study evaluated the ablation volume per pulse (AVP) and required energy needed to ablate 1mm³ (RE, J/mm³) of various stone types at different laser settings with TFL.

Methods

272-µm core-diameter laser fibers (Boston Scientific^©) were connected to a 50 Watts TFL generator (IPG^®). An experimental setup immerged human stones of calcium oxalate monohydrate (COM), uric acid (UA), and cystine (CYS) with a single pulse lasing emission (0.5/0.8/1 J), in contact mode. Stones were dried out before three-dimensional scanning to measure AVP and deduce from the pulse energy (PE) and AVP the RE. A direct comparison with known Ho:YAG’s AVP and RE was then carried out.

Results

AVP for COM stones was significantly greater than those for CYS stones and similar to UA stones (p = 0.02 and p = 0.06, respectively). If AVP increased with PE against COM and UA stones, AVP decreased against CYS stones. 1 J PE resulted in a threefold lower RE compared with other PE for COM stones. On the contrary, RE for CYS increased with PE, whereas PE did not had influence on RE for UA. TFL was associated with greater AVP for COM, but lower for UA and CYS stones compared to Ho:YAG laser.

Conclusion

This in vitro study firstly describes the ablation volume per pulse and required energy to treat a cubic millimeter of three frequent human stone types, and suggest TFL could not be suited for cystine. Therefore, stone composition could be considered when choosing the laser source for lithotripsy.

Traxer O, Keller EX (2019) Thulium fiber laser: the new player for kidney stone treatment? A comparison with Holmium:YAG laser. World J Urol 6:1

Johnson DE, Cromeens DM, Price RE (1992) Use of the holmium:YAG laser in urology. Lasers Surg Med 12(4):353–363CrossRefPubMed

Gupta PK (2007) Is the holmium:YAG laser the best intracorporeal lithotripter for the ureter? A 3-year retrospective study. J Endourol mars 21(3):305–309CrossRef

Keller EX, De Coninck V, Doizi S, Daudon M, Traxer O (2021) Thulium fiber laser: ready to dust all urinary stone composition types? World J Urol juin 39(6):1693–1698CrossRef

Keller EX, De Coninck V, Doizi S, Daudon M, Traxer O (2020) What is the exact definition of stone dust? An in vitro evaluation. World J Urol 8:1

Panthier F, Doizi S, Lapouge P, Chaussain C, Kogane N, Berthe L et al (2020) Comparison of the ablation rates, fissures and fragments produced with 150 µm and 272 µm laser fibers with superpulsed thulium fiber laser: an in vitro study. World J Urol 6:1

Ulvik Ø, Æsøy MS, Juliebø-Jones P, Gjengstø P, Beisland C (2022) Thulium Fibre Laser versus Holmium:YAG for Ureteroscopic Lithotripsy: Outcomes from a Prospective Randomised Clinical Trial. Eur Urol [Internet]. 14 mars 2022 [cité 16 mars 2022];0(0). Disponible sur: https://www.europeanurology.com/article/S0302-2838(22)01669-4/fulltext

Urofrance | Recommandations de bonne pratique pour la prise en charge des calculs et de la lithiase urinaires: diagnostic, traitement, suivi et prévention secondaire - Argumentaire - Urofrance [Internet]. [cité 17 nov 2022]. Disponible sur: https://www.urofrance.org/recommandation/recommandations-de-bonne-pratique-pour-la-prise-en-charge-des-calculs-et-de-la-lithiase-urinaires-diagnostic-traitement-suivi-et-prevention-secondaire-argumentaire/

Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M et al (2016) EAU guidelines on interventional treatment for urolithiasis. Eur Urol mars 69(3):475–482CrossRef

10.

EAU Guidelines on Interventional Treatment for Urolithiasis. - PubMed - NCBI [Internet]. [cité 26 juin 2019]. Disponible sur: https://www.ncbi.nlm.nih.gov/pubmed/26344917

11.

Panthier F, Traxer O, Yonneau L, Lebret T, Berthe L, Illoul L et al (2021) Evaluation of a free 3D software for kidney stones’ surgical planning: «kidney stone calculator» a pilot study. World J Urol 29:1

12.

Panthier F, Ventimiglia E, Berthe L, Chaussain C, Daudon M, Doizi S et al (2020) How much energy do we need to ablate 1 mm³ of stone during Ho:YAG laser lithotripsy? An in vitro study. World J Urol 27:1

13.

Daudon M (2004) Analysis and classification of calculi: contribution to the etiology of calculous disease. Rev Med Suisse Romande août 124(8):445–453

14.

3D Slicer [Internet]. [cité 10 mai 2019]. Disponible sur: https://www.slicer.org/

15.

Panthier F, Doizi S, Illoul L, Berthe L, Traxer O (2020) Developing Free Three-dimensional Software for Surgical Planning for Kidney Stones: Volume is Better than Diameter. Eur Urol Focus [Internet]. 24 juin 2020 [cité 24 juin 2020]; Disponible sur: http://www.sciencedirect.com/science/article/pii/S2405456920301619

16.

Panthier F, Doizi S, Corrales M, Traxer O (2021) Pulsed lasers and endocorporeal laser lithotripsy. Progres En Urol J Assoc Francaise Urol Soc Francaise Urol 27:1

17.

Ventimiglia E, Doizi S, Kovalenko A, Andreeva V, Traxer O (2020) Effect of temporal pulse shape on urinary stone phantom retropulsion rate and ablation efficiency using Holmium:YAG and Super Pulse Thulium Fiber lasers. BJU Int 10:1

18.

Blackmon RL, Irby PB, Fried NM (2011) Comparison of holmium:YAG and thulium fiber laser lithotripsy: ablation thresholds, ablation rates, and retropulsion effects. J Biomed Opt juill 16(7):071403CrossRef

19.

Sierra A, Corrales M, Piñero A, Kolvatzis M, Somani B, Traxer O (2022) Glossary of pre-settings given by laser companies: no consensus! World J Urol 40(9):2313–2321CrossRefPubMed

20.

Sierra A, Corrales M, Piñero A, Traxer O (2022) Thulium fiber laser pre-settings during ureterorenoscopy: Twitter’s experts’ recommendations. World J Urol 4:1

21.

Sierra A, Corrales M, Kolvatzis M, Traxer O (2022) Initial clinical experience with the thulium fiber laser from Quanta System: first 50 reported cases. World J Urol 40(10):2549–2553CrossRefPubMed

22.

Corrales M, Traxer O (2021) Initial clinical experience with the new thulium fiber laser: first 50 cases. World J Urol 15:1

23.

Fedorov A, Beichel R, Kalpathy-Cramer J, Finet J, Fillion-Robin JC, Pujol S et al (2012) 3D slicer as an image computing platform for the Quantitative Imaging Network. Magn Reson Imaging 30(9):1323–1341CrossRefPubMedPubMedCentral

24.

Panthier F, Doizi S, Gorny C, Berthe L, Traxer O (2020) Impact of laser fiber diameter and irrigation fluids on induced bubble stream dynamics with superpulsed thulium fiber laser: an in vitro study. J Endourol 14:1

25.

Panthier F, Germain T, Gorny C, Berthe L, Doizi S, Traxer O (2022) Laser fiber displacement velocity during tm-fiber and Ho:YAG laser lithotripsy: introducing the concept of optimal displacement velocity. J Clin Med 11(1):181CrossRef

26.

Keller EX, de Coninck V, Audouin M, Doizi S, Bazin D, Daudon M et al (2019) Fragments and dust after Holmium laser lithotripsy with or without «Moses technology»: How are they different? J Biophotonics avr 12(4):e201800227CrossRef

27.

Hardy LA, Vinnichenko V, Fried NM (2019) High power holmium:YAG versus thulium fiber laser treatment of kidney stones in dusting mode: ablation rate and fragment size studies. Lasers Surg Med 16:1

28.

Roger C, Abid N, Dubourg L, Auvergnon C, Lemoine S, Machon C (2020) Composition of urinary calculi: Lessons from a French epidemiologic retrospective study. Progres En Urol J Assoc Francaise Urol Soc Francaise Urol 30(6):339–345

29.

Ventimiglia E, Pauchard F, Quadrini F, Sindhubodee S, Kamkoum H, Jiménez Godínez A et al (2021) High- and low-power laser lithotripsy achieve similar results: a systematic review and meta-analysis of available clinical series. J Endourol 7:1

30.

Sierra A, Corrales M, Kolvatzis M, Panthier F, Piñero A, Traxer O (2022) Thermal injury and laser efficiency with holmium YAG and thulium fiber laser—an in vitro study. J Endourol 36(12):1599–1606CrossRefPubMed

Titel: How much energy do we need to ablate 1 cubic millimeter of stone during Thulium Fiber Laser lithotripsy? An in vitro study
verfasst von: Frédéric Panthier
Marie Chicaud
Steeve Doizi
Stessy Kutchukian
Pierre Lapouge
Catalina Solano
Luigi Candela
Michel Daudon
Laurent Berthe
Mariela Corrales
Olivier Traxer
Publikationsdatum: 01.12.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 1/2024
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04761-w

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How much energy do we need to ablate 1 cubic millimeter of stone during Thulium Fiber Laser lithotripsy? An in vitro study