Mp04-13 Investigating the Appropriate Mode of Pulse-Modulated Ho:yag Laser in the Dusting Era

You have accessJournal of UrologyStone Disease: Surgical Therapy (including ESWL) I (MP04)1 May 2024MP04-13 INVESTIGATING THE APPROPRIATE MODE OF PULSE-MODULATED HO:YAG LASER IN THE DUSTING ERA Koki Tominaga, Takaaki Inoue, Takuma Usuda, and Chinnakhet Ketsuwan Koki TominagaKoki Tominaga , Takaaki InoueTakaaki Inoue , Takuma UsudaTakuma Usuda , and Chinnakhet KetsuwanChinnakhet Ketsuwan View All Author Informationhttps://doi.org/10.1097/01.JU.0001008708.00982.a9.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In this study, we investigated different modes of the Ho:YAG laser for lithotripsy during the "dusting era." Artificial stones with a CT value of approximately 1300 HU were used to simulate real-world conditions. Our primary objective was to determine the most effective laser mode in producing smaller stone fragments, specifically those measuring 0.5 mm or less. METHODS: Plaster of Paris-based artificial stones were created and crushed into 2-3 mm-sized fragments and distributed into a total of 1g each, which were utilized in our experiments (Figure 1). The primary endpoint of this study was to compare the mass of stone fragments measuring 0.5 mm or less generated by different laser modes. The secondary endpoints included comparing the mass of stone fragments in the following categories: 0.5 to 1.27 mm, 1.27 to 2.00 mm, and 2.00 mm or more, as well as monitoring irrigation fluid temperature changes. A 200-μm laser fiber was employed with the Lumenis Pulse 120H Ho:YAG laser, using three laser modes: moses contact mode (MC-mode), moses distance mode (MD-mode), and long pulse mode (LP-mode), each set at 0.5 J x 80 Hz. The lithotripsy procedure involved 20 seconds of laser exposure followed by a 10-second pause for 15 cycles, with each mode repeated 7 times. RESULTS: MC-mode outperformed MD-mode in producing stone fragments ≤0.5 mm (p=0.0034) (Figure 2), with no significant differences in other size categories or irrigation fluid temperature changes. Additionally, MD-mode and LP-mode resulted in significantly higher mass loss in fluid compared to MC-mode (p=0.023 and p=0.046, respectively). CONCLUSIONS: In the context of ureteral stone lithotripsy during the "dusting era," our findings suggest that MC-mode is the preferred choice for producing smaller stone fragments, particularly those measuring 0.5 mm or less. These results contribute to optimizing stone fragmentation techniques. Download PPTDownload PPT Source of Funding: This study received equipment support from Boston Scientific Japan, including laser fibers and ureteral access sheaths © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e39 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Koki Tominaga More articles by this author Takaaki Inoue More articles by this author Takuma Usuda More articles by this author Chinnakhet Ketsuwan More articles by this author Expand All Advertisement PDF downloadLoading ...