PURPOSE: To investigate whether heat-induced fiber degradation and loss of power output, which occurred during GreenLight laser vaporization (LV) of the prostate using the first- and second-generation 80 and 120 W laser, are still an issue during LV using the upgraded third generation 180 W GreenLight XPS™ laser. METHODS: Laser beam power output of 53 laser fibers was measured at baseline and after every 25 kJ of delivered energy during routine 180 W GreenLight XPS™ LV in 47 patients with prostatic bladder outflow obstruction. After the procedures, the fiber tips were microscopically examined. RESULTS: The median applied energy per patient was 178 kJ [interquartile range (IQR): 106-247]. Loss of power output during the procedure was detectable in all fibers. After the application of 25, 150, and 250 kJ, the median power output decreased to 77% (IQR 59-87), 57% (IQR 32-71), and 51% (IQR 37-64) of the baseline value. Nine fibers (17%) remained on a relatively high power output level (> 80% of the initial output), while 13 fibers (25%) showed an end-of-procedure power output of less than 20%. Microscopy of the fiber tip revealed mild-to-moderate overall degradation and increasing degradation with higher energy delivered. CONCLUSION: Despite changes in fiber design, heat-induced fiber damage and loss of power output remain an issue during 180 W GreenLight XPS™ LV. Whether modifications of the surgical technique can prevent impairment of fiber performance needs to be further evaluated.
PURPOSE: To investigate whether heat-induced fiber degradation and loss of power output, which occurred during GreenLight laser vaporization (LV) of the prostate using the first- and second-generation 80 and 120 W laser, are still an issue during LV using the upgraded third generation 180 W GreenLight XPS™ laser. METHODS: Laser beam power output of 53 laser fibers was measured at baseline and after every 25 kJ of delivered energy during routine 180 W GreenLight XPS™ LV in 47 patients with prostatic bladder outflow obstruction. After the procedures, the fiber tips were microscopically examined. RESULTS: The median applied energy per patient was 178 kJ [interquartile range (IQR): 106-247]. Loss of power output during the procedure was detectable in all fibers. After the application of 25, 150, and 250 kJ, the median power output decreased to 77% (IQR 59-87), 57% (IQR 32-71), and 51% (IQR 37-64) of the baseline value. Nine fibers (17%) remained on a relatively high power output level (> 80% of the initial output), while 13 fibers (25%) showed an end-of-procedure power output of less than 20%. Microscopy of the fiber tip revealed mild-to-moderate overall degradation and increasing degradation with higher energy delivered. CONCLUSION: Despite changes in fiber design, heat-induced fiber damage and loss of power output remain an issue during 180 W GreenLight XPS™ LV. Whether modifications of the surgical technique can prevent impairment of fiber performance needs to be further evaluated.
Authors: Thomas R W Herrmann; Evangelos N Liatsikos; Udo Nagele; Olivier Traxer; Axel S Merseburger Journal: Eur Urol Date: 2012-01-17 Impact factor: 20.096
Authors: Matthias Oelke; Alexander Bachmann; Aurélien Descazeaud; Mark Emberton; Stavros Gravas; Martin C Michel; James N'dow; Jørgen Nordling; Jean J de la Rosette Journal: Eur Urol Date: 2013-03-13 Impact factor: 20.096
Authors: Alexander Bachmann; Gordon H Muir; Edward J Collins; Benjamin B Choi; Shahin Tabatabaei; Oliver M Reich; Fernando Gómez-Sancha; Henry H Woo Journal: Eur Urol Date: 2011-12-02 Impact factor: 20.096
Authors: James A Thomas; Andrea Tubaro; Neil Barber; Frank d'Ancona; Gordon Muir; Ulrich Witzsch; Marc-Oliver Grimm; Joan Benejam; Jens-Uwe Stolzenburg; Antony Riddick; Sascha Pahernik; Herman Roelink; Filip Ameye; Christian Saussine; Franck Bruyère; Wolfgang Loidl; Tim Larner; Nirjan-Kumar Gogoi; Richard Hindley; Rolf Muschter; Andrew Thorpe; Nitin Shrotri; Stuart Graham; Moritz Hamann; Kurt Miller; Martin Schostak; Carlos Capitán; Helmut Knispel; Alexander Bachmann Journal: Eur Urol Date: 2015-08-15 Impact factor: 20.096