Laser Fiber and Flexible Ureterorenoscopy: The Safety Distance Concept

Talso, Michele; Emiliani, Esteban; Haddad, M.; Berthe, Laurent; Baghdadi, Mohammed; Montanari, Emanuele; Traxer, Olivier

doi:10.1089/end.2016.0209

Cited by 46 publications

(27 citation statements)

References 13 publications

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“…1) [24]. The Holmium:YAG laser operates at 2120 nm and is highly absorbed in liquid water, leading to a rapid formation of a vapor bubble after emission in pulsed mode [25]. This interaction with water also adds to the safety profile of Holmium:YAG lasers, as the optical penetration depth is limited to 400 µm and coagulation of tissue beyond this distance only occurs in the high pulse energy range [7,26].…”

Section: Water Absorption Peakmentioning

confidence: 99%

Thulium fiber laser: the new player for kidney stone treatment? A comparison with Holmium:YAG laser

2019

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Purpose To compare the operating modes of the Holmium:YAG laser and Thulium fiber laser. Additionally, currently available literature on Thulium fiber laser lithotripsy is reviewed. Materials and methods Medline, Scopus, Embase, and Web of Science databases were searched for articles relating to the operating modes of Holmium:YAG and Thulium fiber lasers, including systematic review of articles on Thulium fiber laser lithotripsy. Results The laser beam emerging from the Holmium:YAG laser involves fundamental architectural design constraints compared to the Thulium fiber laser. These differences translate into multiple potential advantages in favor of the Thulium fiber laser: four-fold higher absorption coefficient in water, smaller operating laser fibers (50-150 µm core diameter), lower energy per pulse (as low as 0.025 J), and higher maximal pulse repetition rate (up to 2000 Hz). Multiple comparative in vitro studies suggest a 1.5-4 times faster stone ablation rate in favor of the Thulium fiber laser. Conclusions The Thulium fiber laser overcomes the main limitations reported with the Holmium:YAG laser relating to lithotripsy, based on preliminary in vitro studies. This innovative laser technology seems particularly advantageous for ureteroscopy and may become an important milestone for kidney stone treatment.

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Section: Water Absorption Peakmentioning

confidence: 99%

Thulium fiber laser: the new player for kidney stone treatment? A comparison with Holmium:YAG laser

2019

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“…Once the laser fiber is inserted into the working channel, it is recommended to place the laser fiber tip until reaching one-quarter of the endoscope screen to avoid any fURS tip damage caused by the cavitation bubble created by laser activation (Fig. 3) [35].…”

Section: Lithotripsy and Fragment Extractionmentioning

confidence: 99%

Flexible ureteroscopy: technique, tips and tricks

Doizi

Traxer

2017

Urolithiasis

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During the last decades, the surgical management of kidney stones benefited of many technological advances and one of them is the development of flexible ureteroscopy (fURS). This tool, ancillary equipment such as graspers and baskets, and lithotripsy technique with Holmium:YAG laser underwent many improvements leading to a widening of its indications with diagnostic and therapeutic management of upper urinary tract pathologies such as urolithiasis and urothelial tumors. The objective of this review is to describe the surgical technique for fURS as well as tips and tricks for the treatment of renal stones.

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“…Next, access the target stones. It is advisable to keep the laser fiber tip out of the scope as far as one‐quarter of the screen diameter, called “safety distance,” to avoid f‐URS damage due to laser bubble rebound and stone rebound . The surgical technique is crucial for procedure speed.…”

Section: Rirsmentioning

confidence: 99%

“…It is advisable to keep the laser fiber tip out of the scope as far as onequarter of the screen diameter, called "safety distance," to avoid f-URS damage due to laser bubble rebound and stone rebound. 36 The surgical technique is crucial for procedure speed. The laser setting to serve the operator's aim in various situations during surgery is selected as described previously.…”

Section: Tips and Tricksmentioning

confidence: 99%

Current trends and pitfalls in endoscopic treatment of urolithiasis

et al. 2017

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Current development of endoscopic technology, lithotripters, and stoneretrieval devices has expanded the indications for retrograde and antegrade endoscopic therapy in the management of urolithiasis. This technology has also resulted in minimally invasive therapy. As surgeons' experience of endourological procedures with the newer instruments has become integrated, the surgical technique and indications for urolithiasis have also changed in the past few years. The present review provides an overview of endourological procedures for upper urinary tract stones and the key points related to surgical techniques.

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Laser Fiber and Flexible Ureterorenoscopy: The Safety Distance Concept

Cited by 46 publications

References 13 publications

Thulium fiber laser: the new player for kidney stone treatment? A comparison with Holmium:YAG laser

Thulium fiber laser: the new player for kidney stone treatment? A comparison with Holmium:YAG laser

Flexible ureteroscopy: technique, tips and tricks

Current trends and pitfalls in endoscopic treatment of urolithiasis

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