Mp63-02 Turning Up the Heat: Laser Lithotripsy Simulation of the Moses 2.0 Holmium Laser in an Anatomic Pelvicalyceal Model

You have accessJournal of UrologyStone Disease: Basic Research & Pathophysiology (MP63)1 May 2024MP63-02 TURNING UP THE HEAT: LASER LITHOTRIPSY SIMULATION OF THE MOSES 2.0 HOLMIUM LASER IN AN ANATOMIC PELVICALYCEAL MODEL Christopher Wanderling, Aaron Saxton, Dennis Phan, Karen Doersch, Lauren Shepard, Nathan Schuler, Timothy Campbell, Stephen Hassig, Thomas Osinski, Scott Quarrier, and Ahmed Ghazi Christopher WanderlingChristopher Wanderling , Aaron SaxtonAaron Saxton , Dennis PhanDennis Phan , Karen DoerschKaren Doersch , Lauren ShepardLauren Shepard , Nathan SchulerNathan Schuler , Timothy CampbellTimothy Campbell , Stephen HassigStephen Hassig , Thomas OsinskiThomas Osinski , Scott QuarrierScott Quarrier , and Ahmed GhaziAhmed Ghazi View All Author Informationhttps://doi.org/10.1097/01.JU.0001009436.52988.91.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urologists are efficiently performing lithotripsy with high-powered lasers. Increasing power may cause increased temperatures with lithotripsy. Thermal dose is an important measure of thermal load. The threshold of thermal injury (TD43)- when tissue damage occurs- is a standard measure for tissue denaturation, occurring when temperature is sustained at 43OC >120 equivalent minutes. The aim of this study is to evaluate temperatures, thermal dose, and time to TD43 with 4 laser settings in a pelvicalyceal (PCS) model. METHODS: Utilizing high-fidelity, 3D-printed hydrogel PCS models submerged in a body-temperature water bath, lithotripsy via flexible ureteroscopy, with the Moses 2.0 Ho:YAG laser was performed on a synthetic stone implanted in a PCS. At a standard power (40W) and irrigation (17.9ml/min), we evaluated 3 operator duty cycles (ODC) with varied laser-time intervals at 4 laser settings. Temperature was measured in real time, at the stone and ureteropelvic junction (UPJ). Thermal dose was calculated with the Sapareto and Dewey formula. Statistics were completed for thermal dose (AUC and Kruskal-Wallis) and temperature (linear regression). RESULTS: TD43 was reached for all 100% and 75% ODCs at the stone and UPJ for each laser setting. At the stone, TD43 was generally reached faster with greater cumulative thermal doses and temperatures. Higher ODCs and longer laser activation time resulted in greater thermal doses and temperatures. Shorter laser-off times reached TD43 faster. Although there was no general trend for which laser settings delivered the greatest thermal loads, there were statistically significant differences for the thermal dose and temperature between laser settings (Table 1). CONCLUSIONS: Urologists must be diligent when treating stones as dangerous temperatures and TD43 can be reached. To reduce thermal injury risks, urologists should consider reducing ODCs and laser-on time along with taking laser breaks. Laser energy and frequency may play an important role in thermal load delivery during lithotripsy. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1031 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Christopher Wanderling More articles by this author Aaron Saxton More articles by this author Dennis Phan More articles by this author Karen Doersch More articles by this author Lauren Shepard More articles by this author Nathan Schuler More articles by this author Timothy Campbell More articles by this author Stephen Hassig More articles by this author Thomas Osinski More articles by this author Scott Quarrier More articles by this author Ahmed Ghazi More articles by this author Expand All Advertisement PDF downloadLoading ...