Publication
In vitro fragmentation efficiency of holmium: yttrium-aluminum-garnet (YAG) laser lithotripsy--a comprehensive study encompassing different frequencies, pulse energies, total power levels and laser fibre diameters
| dc.contributor.author | Kronenberg, P | |
| dc.contributor.author | Traxer, O | |
| dc.date.accessioned | 2016-04-08T15:17:02Z | |
| dc.date.available | 2016-04-08T15:17:02Z | |
| dc.date.issued | 2014 | |
| dc.description.abstract | OBJECTIVE: To assess the fragmentation (ablation) efficiency of laser lithotripsy along a wide range of pulse energies, frequencies, power settings and different laser fibres, in particular to compare high- with low-frequency lithotripsy using a dynamic and innovative testing procedure free from any human interaction bias. MATERIALS AND METHODS: An automated laser fragmentation testing system was developed. The unmoving laser fibres fired at the surface of an artificial stone while the stone was moved past at a constant velocity, thus creating a fissure. The lithotripter settings were 0.2-1.2 J pulse energies, 5-40 Hz frequencies, 4-20 W power levels, and 200 and 550 μm core laser fibres. Fissure width, depth, and volume were analysed and comparisons between laser settings, fibres and ablation rates were made. RESULTS: Low frequency-high pulse energy (LoFr-HiPE) settings were (up to six times) more ablative than high frequency-low pulse energy (HiFr-LoPE) at the same power levels (P < 0.001), as they produced deeper (P < 0.01) and wider (P < 0.001) fissures. There were linear correlations between pulse energy and fragmentation volume, fissure width, and fissure depth (all P < 0.001). Total power did not correlate with fragmentation measurements. Laser fibre diameter did not affect fragmentation volume (P = 0.81), except at very low pulse energies (0.2 J), where the large fibre was less efficient (P = 0.015). CONCLUSIONS: At the same total power level, LoFr-HiPE lithotripsy was most efficient. Pulse energy was the key variable that drove fragmentation efficiency. Attention must be paid to prevent the formation of time-consuming bulky debris and adapt the lithotripter settings to one's needs. As fibre diameter did not affect fragmentation efficiency, small fibres are preferable due to better scope irrigation and manoeuvrability. | pt_PT |
| dc.identifier.citation | BJU Int. 2014 Aug;114(2):261-7 | pt_PT |
| dc.identifier.doi | 10.1111/bju.12567 | pt_PT |
| dc.identifier.issn | 1464-410X | |
| dc.identifier.uri | http://hdl.handle.net/10400.10/1606 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | British Association of Urological Surgeons | pt_PT |
| dc.relation.publisherversion | http://onlinelibrary.wiley.com/doi/10.1111/bju.12567/epdf | pt_PT |
| dc.subject | Urinary calculi | pt_PT |
| dc.subject | Laser lithotripsy | pt_PT |
| dc.subject | Cálculos urinários | pt_PT |
| dc.subject | Litotrícia a laser | pt_PT |
| dc.title | In vitro fragmentation efficiency of holmium: yttrium-aluminum-garnet (YAG) laser lithotripsy--a comprehensive study encompassing different frequencies, pulse energies, total power levels and laser fibre diameters | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.conferencePlace | Oxford | pt_PT |
| oaire.citation.endPage | 267 | pt_PT |
| oaire.citation.startPage | 261 | pt_PT |
| oaire.citation.title | BJU international | pt_PT |
| oaire.citation.volume | 114 | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |