Initial clinical experience with the pulsed solid-state thulium YAG laser from Dornier during RIRS: first 25 cases
Article dans une revue avec comité de lecture
Author
Date
2023Journal
World Journal of UrologyAbstract
Introduction Holmium:yttrium–aluminium–garnet (Ho:YAG) and thulium fiber (TFL) lasers are currently the two laser
sources recommended for endocorporeal laser lithotripsy (ELL). Recently, the pulsed-thulium:YAG (Tm:YAG) laser was
also proposed for ELL, as an answer to both Ho:YAG and TFL limitations. We aimed to evaluate the efficiency, safety, and
laser settings of Tm:YAG laser in ELL during retrograde intrarenal surgery (RIRS).
Methods A prospective study of the first 25 patients with ureteral and renal stones who underwent RIRS using the Thulio
(pulsed-Tm:YAG, Dornier©, Germany) was performed in a single center. 272 μm laser fibers were used. Stone size, stone
density, laser-on time (LOT) and laser settings were recorded. We also assessed the ablation speed (mm 3 /s), Joules/mm 3 and
laser power (W) values for each procedure. Postoperative results, such as stone-free rate (SFR) and zero fragments rate (ZFR)
were also recorded.
Results A total of 25 patients were analyzed (Table 1). The median (IQR) age was 55 (44–72) years old. Median (IQR) stone
volume was 2849 (916–9153)mm3
. Median (IQR) stone density was 1000 (600–1174)HU. Median (IQR) pulse energy, pulse
rate and total power were 0.6 (0.6–0,8)J, 15(15–20)Hz and 12(9–16)W, respectively. All procedures used “Captive Frag-
menting” pulse modulation (Table 2). The median (IQR) J/mm 3 was 14,8 (6–21). The median (IQR) ablation rate was 0,75
(0,46–2)mm 3 /s. One postoperative complications occurred (streinstrasse). SFR and ZFR were 95% and 55%, respectively.
Conclusion The pulsed-Tm:YAG laser is a safe and effective laser source for lithotripsy during RIRS, using low pulse energy
and low pulse frequency.
Files in this item
Related items
Showing items related by title, author, creator and subject.
-
Article dans une revue avec comité de lecturePANTHIER, Frédéric; GERMAIN, Thibault; GORNY, Cyril; BERTHE, Laurent; DOIZI, Steeve; TRAXER, Olivier (MDPI, 2022-01)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 ...
-
Article dans une revue avec comité de lectureUZAN, Audrey; CHIRON, Paul; PANTHIER, Frédéric; HADDAD, Mattieu; BERTHE, Laurent; DOIZI, Steeve; TRAXER, Olivier (2021)Objectives: To compare the risk of laser fiber fracture between Ho:YAG laser and Thulium Fiber Laser (TFL) with different laser fiber diameters, laser settings, and fiber bending radii. METHODS: Lengths of 200, 272, and ...
-
Article dans une revue avec comité de lecturePANTHIER, Frédéric; VENTIMIGLIA, Eugenio; BERTHE, Laurent; CHAUSSAIN, Catherine; DAUDON, Michel; DOIZI, Steeve; TRAXER, Olivier (Springer Verlag, 2020)Introduction: Holmium:yttrium–aluminium–garnet (Ho:YAG) is currently the gold standard for lithotripsy for the treatment of all known urinary stone types. Stone composition and volume are major determinants of the lithotripsy. ...
-
Article dans une revue avec comité de lecturePANTHIER, Frédéric; GERMAIN, T.; BERTHE, Laurent; DOIZI, Steeve; TRAXER, Olivier (Elsevier Masson, 2020)La vitesse optimale de déplacement (VOD) de la fibre laser pour réaliser la pulvérisation lithiasique est une variable inconnue à ce jour, autant pour le laser thulium fibré (TFL) que pour le laser Holmium :YAG (Ho :YAG). ...
-
Article dans une revue avec comité de lecturePANTHIER, Frédéric; LAPOUGE, Pierre; DOIZI, Steeve; DRAGOS, L.; BERTHE, Laurent; TRAXER, Olivier (Elsevier Masson, 2020)L’étude in vitro de la lithotritie laser (LL) utilise des calculs humains (CH) ou synthétiques (CS). Devant l’augmentation de la pulvérisation laser (Dusting), peu d’échantillons humains sont disponibles. Les CS sont donc ...