Alba Sierra1,2, Mariela Corrales1,2, Adrià Piñero1,2, Merkourios Kolvatzis1,2, Bhaskar Somani3, Olivier Traxer4,5. 1. Sorbonne University GRC Urolithiasis No. 20 Tenon Hospital, 75020, Paris, France. 2. Department of Urology AP-HP, Tenon Hospital, Sorbonne University, 75020, Paris, France. 3. University Hospital Southampton NHS Trust, Southampton, UK. 4. Sorbonne University GRC Urolithiasis No. 20 Tenon Hospital, 75020, Paris, France. olivier.traxer@aphp.fr. 5. Department of Urology AP-HP, Tenon Hospital, Sorbonne University, 75020, Paris, France. olivier.traxer@aphp.fr.
Abstract
INTRODUCTION: Since the construction of the first laser, many companies around the world have contributed to the development of new lasers technologies. To be user-friendly, some companies have developed a pre-setting mode in their laser devices. We aimed to review and compare all laser companies' pre-settings (PS) already established in the market. MATERIALS AND METHODS: An online search of holmium:YAG (Ho:YAG) and thulium fiber laser (TFL) devices was carried out. Manual and PS mode, pulse width and pulse modulation technology data were collected. The PS parameters were collected directly from the brochure devices or by asking the companies consulting agents. RESULTS: Thirty-nine laser devices were analyzed (33 Ho:YAG and 6 TFL). The power range varies from 15 to 152 W and 35 W to 60 W for Ho:YAG and TFL, respectively. PS are present in 66% of Ho:YAG lasers and the 33% of TFL. Long-pulse modes can be modified in 12 Ho:YAG and 1 TFL lasers. The median (IQR) PS for dusting stones with Ho:YAG laser is 0.4 J (0.2-1), 21.5 Hz (5-120), and 10 W (1.5-28) for energy, frequency and power, respectively; for Ho:YAG fragmentation is 0.8 J (0.3-5), 10 (3-15) Hz and 5 (1.5-50) W for energy, frequency, and power, respectively; and for popcorn is 0.8 J (0.4-1.2), 10 Hz (6-15) and 5 W (4-18) for energy, frequency, and power, respectively. Dusting and fragmentation mode of Rocamed MH01 and EMS LaserClast 35 are programmed according to the stone type. Most of these settings do not depend on the size of the fiber being used nor the location and type of stone. For TFL, the pre-sets are divided in bladder stone, dusting, fine dusting, fragmentation, and ureteral stone. CONCLUSION: There is a huge variability regarding pre-sets offered by companies because there is no consensus. Pre-sets should provide a range to work efficacy and safety.
INTRODUCTION: Since the construction of the first laser, many companies around the world have contributed to the development of new lasers technologies. To be user-friendly, some companies have developed a pre-setting mode in their laser devices. We aimed to review and compare all laser companies' pre-settings (PS) already established in the market. MATERIALS AND METHODS: An online search of holmium:YAG (Ho:YAG) and thulium fiber laser (TFL) devices was carried out. Manual and PS mode, pulse width and pulse modulation technology data were collected. The PS parameters were collected directly from the brochure devices or by asking the companies consulting agents. RESULTS: Thirty-nine laser devices were analyzed (33 Ho:YAG and 6 TFL). The power range varies from 15 to 152 W and 35 W to 60 W for Ho:YAG and TFL, respectively. PS are present in 66% of Ho:YAG lasers and the 33% of TFL. Long-pulse modes can be modified in 12 Ho:YAG and 1 TFL lasers. The median (IQR) PS for dusting stones with Ho:YAG laser is 0.4 J (0.2-1), 21.5 Hz (5-120), and 10 W (1.5-28) for energy, frequency and power, respectively; for Ho:YAG fragmentation is 0.8 J (0.3-5), 10 (3-15) Hz and 5 (1.5-50) W for energy, frequency, and power, respectively; and for popcorn is 0.8 J (0.4-1.2), 10 Hz (6-15) and 5 W (4-18) for energy, frequency, and power, respectively. Dusting and fragmentation mode of Rocamed MH01 and EMS LaserClast 35 are programmed according to the stone type. Most of these settings do not depend on the size of the fiber being used nor the location and type of stone. For TFL, the pre-sets are divided in bladder stone, dusting, fine dusting, fragmentation, and ureteral stone. CONCLUSION: There is a huge variability regarding pre-sets offered by companies because there is no consensus. Pre-sets should provide a range to work efficacy and safety.
Authors: Ali H Aldoukhi; Timothy L Hall; Khurshid R Ghani; Adam D Maxwell; Brian MacConaghy; William W Roberts Journal: J Endourol Date: 2018-07-13 Impact factor: 2.942
Authors: Brian R Matlaga; Ben Chew; Brian Eisner; Mitchell Humphreys; Bodo Knudsen; Amy Krambeck; Dirk Lange; Michael Lipkin; Nicole L Miller; Manoj Monga; Vernon Pais; Roger L Sur; Ojas Shah Journal: J Endourol Date: 2017-11-27 Impact factor: 2.942