Mp63-01 the Impact of Irrigation Fluid Temperature on Superpulse Thulium Fiber Laser Stone Ablation

You have accessJournal of UrologyStone Disease: Basic Research & Pathophysiology (MP63)1 May 2024MP63-01 THE IMPACT OF IRRIGATION FLUID TEMPERATURE ON SUPERPULSE THULIUM FIBER LASER STONE ABLATION Andrei Dragos Cumpanas, Nitesh Katta, Yi Xi Wu, Antonio R. H. Gorgen, Jacob C. Tsai, Thao N. Vu, Mariah C. Hernandez, Kelvin Vo, Jaime Altamirano Villaroel, Bruce Gao, Zachary E. Tano, Pengbo Jiang, Roshan M. Patel, Thomas Milner, Jaime Landman, and Ralph V. Clayman Andrei Dragos CumpanasAndrei Dragos Cumpanas , Nitesh KattaNitesh Katta , Yi Xi WuYi Xi Wu , Antonio R. H. GorgenAntonio R. H. Gorgen , Jacob C. TsaiJacob C. Tsai , Thao N. VuThao N. Vu , Mariah C. HernandezMariah C. Hernandez , Kelvin VoKelvin Vo , Jaime Altamirano VillaroelJaime Altamirano Villaroel , Bruce GaoBruce Gao , Zachary E. TanoZachary E. Tano , Pengbo JiangPengbo Jiang , Roshan M. PatelRoshan M. Patel , Thomas MilnerThomas Milner , Jaime LandmanJaime Landman , and Ralph V. ClaymanRalph V. Clayman View All Author Informationhttps://doi.org/10.1097/01.JU.0001009436.52988.91.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Laser physics has demonstrated that as the temperature of a medium rises, the amount of energy delivered to the target increases. We hypothesized that this effect could possibly enhance laser lithotripsy. Accordingly, we evaluated the effect of increased irrigation fluid temperature on the degree of stone ablation during superpulse Thulium fiber laser (sTFL) lithotripsy among 360 urolithis of six different compositions. METHODS: 360 human uroliths were divided based on their chemical composition: calcium oxalate monohydrate (COM), cystine (CYS), struvite (STR), calcium phosphate (CP), uric acid (UA), and calcium oxalate dihydrate (COD). With the tip of a 200 µm sTFL fiber in contact with each stone, while immersed in 0.9% NaCl, at four different temperatures (25°C, 37°C,44°C, and 60°C) a single laser pulse was delivered at 0.1 J, 0.5 J, or 1.5 J. Optical coherence tomography was applied to assess the volume of the single-pulse ablation cone. The difference in mean ablation cone volume was assessed by ANOVA testing and Tukey post-hoc analysis. A multivariate generalized model was developed for each stone type to account for the impact of fluid temperature and laser energy on stone ablation. RESULTS: Warmer fluid temperatures yielded greater ablation cone volumes for most energy settings and for all non-UA stones (Figure 1). When accounting for individual chemical compositions, stones with more tensile strength and a higher thermal threshold (i.e., COM and CYS) benefited the most from increasing the temperature of the irrigation fluid. More frangible stones (i.e., CP and STR) were only mildly affected by temperature. Of note, the effect of increasing fluid temperature is modest in comparison to the impact of increasing laser pulse energy; a large increase (i.e. 7°C) in fluid temperature is equivalent to a minor (i.e., 0.1J) increase in delivered energy (Table 1). CONCLUSIONS: For non-UA stones, sTFL stone ablation efficiency increases with warmer irrigation fluid. The effect, albeit modest in comparison to laser pulse energy, was most notable for COM and CYS stones. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1030 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Andrei Dragos Cumpanas More articles by this author Nitesh Katta More articles by this author Yi Xi Wu More articles by this author Antonio R. H. Gorgen More articles by this author Jacob C. Tsai More articles by this author Thao N. Vu More articles by this author Mariah C. Hernandez More articles by this author Kelvin Vo More articles by this author Jaime Altamirano Villaroel More articles by this author Bruce Gao More articles by this author Zachary E. Tano More articles by this author Pengbo Jiang More articles by this author Roshan M. Patel More articles by this author Thomas Milner More articles by this author Jaime Landman More articles by this author Ralph V. Clayman More articles by this author Expand All Advertisement PDF downloadLoading ...