Mp78-17 the Impact of Laser Settings on Nephrolithiathiasis: Clinical Observations From the Post-Market Soltive Registry and Team of Worldwide Endurological Reserachers’ (T.O.W.E.R.) Consortium

You have accessJournal of UrologyStone Disease: Surgical Therapy (Including ESWL) V (MP78)1 May 2024MP78-17 THE IMPACT OF LASER SETTINGS ON NEPHROLITHIATHIASIS: CLINICAL OBSERVATIONS FROM THE POST-MARKET SOLTIVE REGISTRY AND TEAM OF WORLDWIDE ENDUROLOGICAL RESERACHERS' (T.O.W.E.R.) CONSORTIUM Mitchell R. Humphreys, Ben H. Chew, Wilson R. Molina, Bodo E. Knudsen, Mantu Gupta, Duane D. Baldwin, Victor K. F. Wong, Peter Kronenberg, Palle Osther, and Olivier Traxer Mitchell R. HumphreysMitchell R. Humphreys , Ben H. ChewBen H. Chew , Wilson R. MolinaWilson R. Molina , Bodo E. KnudsenBodo E. Knudsen , Mantu GuptaMantu Gupta , Duane D. BaldwinDuane D. Baldwin , Victor K. F. WongVictor K. F. Wong , Peter KronenbergPeter Kronenberg , Palle OstherPalle Osther , and Olivier TraxerOlivier Traxer View All Author Informationhttps://doi.org/10.1097/01.JU.0001008856.05210.73.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Thulium fiber lasers (TFL) have emerged as an effective treatment for endoscopic lithotripsy. In this prospective, international registry, the Endourological Society's T.O.W.E.R. Research Consortium reports their experience utilizing the TFL, SOLTIVE™ SuperPulsed Laser (Gyrus ACMI, Inc. Brooklyn Park, MN) to provide real-world data. The objective was to determine the impact of surgeon laser setting alterations during treatment of ureteral and kidney stones. METHODS: Patients undergoing lithotripsy for ureteral (n=103) and kidney (n=258) stones with 3 month (m) data using TFL laser were prospectively treated in 8 international institutions between 12/2021- 4/2023. Imaging performed for stone free rate (SFR) reporting: 28% CT scan, 43% US, 25% KUB, 14% not reported. Baseline characteristics, adverse events, and post-operative outcomes were collected. All stones were treated with the following settings for the 1st minute of laser time (subsequent changes at surgeon discretion): Left Pedal (Kidney) – 0.2J, 100Hz; 0.4J, 40Hz, 0.05J, 400Hz Right Pedal (Kidney) – 0.6 J, 30 Hz; 1 J, 20 Hz; 0.1 J, 200 Hz Left Pedal (Ureter) – 0.05 J, 50 Hz; 0.15 J, 14 Hz Right Pedal (Ureter) – 0.1 J, 50 Hz; 0.1 J, 20 Hz. RESULTS: Laser setting were changed in 46% of kidney stone cases. The changed group had larger stones (12.53±5.79 mm vs 9.94±5.29 mm, p<0.001), but no significant difference in 3m SFR (71.22% vs 62.18%, p=0.1236). Comparing the initial (first half of cases) to the later, settings were more frequently changed initially (52.34% vs 40%, p=0.0467) and the 3m SFR was higher (72.66% vs 61.54 %, p=0.0575). Laser settings were changed in 60% of ureteral cases but there was no difference in stone size (8.6±7.5 mm vs 8.5±6.9 mm, p=0.8562) or in 3m SFR (79.03% vs 92.68%, p=0.094). Setting were more frequently altered in the first half of cases (63.46% vs 56.86%, p=0.4393) and SFR at 3 months were slightly higher (88.46% vs 80.39%, p=0.2538). Figure 1 shows the influence of stone diameter on laser setting changes. CONCLUSIONS: Surgeons altered the default TFL settings more for ureteral stones and large kidney stones. In both groups, initial cases saw more setting alterations consistent with learning curves and attempts to better understand TFL capabilities. Download PPT Source of Funding: Olympus Inc © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1270 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mitchell R. Humphreys More articles by this author Ben H. Chew More articles by this author Wilson R. Molina More articles by this author Bodo E. Knudsen More articles by this author Mantu Gupta More articles by this author Duane D. Baldwin More articles by this author Victor K. F. Wong More articles by this author Peter Kronenberg More articles by this author Palle Osther More articles by this author Olivier Traxer More articles by this author Expand All Advertisement PDF downloadLoading ...