[Experimental verification of thulium lithotripsy].

Author(s) Rapoport, L.M.; Vinarov, A.Z.; Sorokin, N.I.; Dymov, A.M.; Enikeev, D.V.; Tsarichenko, D.G.; Lekarev, Y.; Klimov, R.E.; Andreeva, V.A.; Kovalenko, A.A.
Journal Urologiia
Date Published 2018 Dec
Abstract

AIM: Experimental evaluation of the efficacy and safety of lithotripsy using a new pulsed thulium fiber laser operating at a wavelength of 1.94 microns, peak power of 500 watts (maximum average power of 50 watts) by comparing it with a holmium laser operating at a wavelength of 2.1 microns (average maximum power 100 W and 120 W).

RELEVANCE: The proportion of minimally invasive surgery in the management of urolithiasis, including retrograde intrarenal surgery, is steadily growing. The most appropriate tool for stone destruction is a laser. To date, the gold standard of minimally invasive surgical treatment of nephrolithiasis is holmium laser lithotripsy, which uses a laser on yttrium-aluminum-garnet activated by holmium ions (Ho: YAG) operating at a wavelength of 2.1 m. However, in recent years, lasers on a Tm-activated fiber with a wavelength of 1.94 m have become increasingly popular since the water absorption coefficient for the Tm radiation of a fiber laser is 5.5 times higher than for a Ho: YAG laser and in 2.2 times higher than for the Tm: YAG laser. This difference may translate into greater effectiveness and speed of stone crushing, which in turn leads to shorter operating time.

MATERIALS AND METHODS: This article describes physical foundations of holmium and thulium laser radiation, the mechanisms of stone fragmentation, data from a series of experiments comparing the efficiency and safety of ex-vivo lithotripsy using a holmium solid-state laser with a wavelength of 2.1 m and a thulium fiber laser with a wavelength of 1.94 m.

RESULTS: The study findings suggest that the STA IRE-Polyus thulium fiber laser operating at a wavelength of 1.94 microns and a maximum power of 500 watts has several advantages over the holmium laser in the stone fragmentation in urological practice.

CONCLUSION: The results of the experimental work allow us to conclude that the use of a thulium fiber laser operating at a wavelength of 1.94 m and a maximum peak power of 500 W enables highly effective and safe lithotripsy.

ISSN 1728-2985
Citation Rapoport LM, Vinarov AZ, Sorokin NI, Dymov AM, Enikeev DV, Tsarichenko DG, et al. [Experimental verification of thulium lithotripsy]. Urologiia. 2018;(5):74-80.

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