Thermal effect of holmium laser during ureteroscopic lithotripsy

Springer Science and Business Media LLC - Tập 20 Số 1 - 2020
Hui Liang1, Lijian Liang1, Yin Yu1, Bin Huang1, Jianan Chen1, Chaoguo Wang1, Zhangguo Zhu1, Xiaozhong Liang1
1Department of Urology, Xinchang County Hospital of Traditional Chinese Medicine, Shaoxing, Zhejiang Province, China

Tóm tắt

Abstract Background Holmium laser lithotripsy is the most common technique for the management of ureteral stone. Studies founded that holmium laser firing can produce heat which will cause thermal injury towards ureter. The aim of our current study is to explore factors affecting thermal effect of holmium laser during ureteroscopic lithotripsy. Methods An in vitro experimental model is design to simulate the ureteroscopic lithotripsy procedure. Different laser power settings (10w (0.5JX20Hz, 1.0 JX10Hz), 20w (1.0 JX20Hz, 2.0 JX10Hz), 30w (1.5JX20Hz, 3.0 JX10Hz)) with various firing time (3 s, 5 s, 10s) and irrigation flow rates(10 ml/min, 15 ml/min, 20 ml/min and 30 ml/min) were employed in the experiment. The temperature around the laser tip was recorded by thermometer. Results The temperature in the “ureter” rises significantly with the increasing laser power, prolonging firing time and reducing irrigation flow. The highest regional temperature is 78.0 °C at the experimental set-up, and the lowest temperature is 23.5 °C. Higher frequency setting produces more heat at the same power. Laser power < =10w, irrigation flow> = 30 ml/min and “high-energy with low-frequency” can permit a safe working temperature. Conclusion We clarify that the thermal effect of holmium laser is related with both laser working parameters and irrigation flow. The proper setting is the key factor to ensure the safety during ureteroscopic holmium laser lithotripsy.

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