Temperature Changes Inside the Kidney: What Happens During Holmium:Yttrium-Aluminium-Garnet Laser Usage?

Butticè, Salvatore; Şener, Tarık Emre; Proietti, Silvia; Dragoş, L.; Tefik, Tzevat; Doizi, Steeve; Traxer, Olivier

doi:10.1089/end.2015.0747

Cited by 55 publications

(29 citation statements)

References 31 publications

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“…More recent in-vitro studies confirm our results. Butticè et al 13 used the K-box ® polyurethane model (Coloplast, Humlebaek, Denmark) and demonstrated rapid rises in temperatures similar to our results. Their study showed a more pronounced rise with a larger laser fiber (272 versus 200 μm); however, this was not statistically significant.…”

Section: Looked Atsupporting

confidence: 88%

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Holmium-YAG laser: impact of pulse energy and frequency on local fluid temperature in an in-vitro obstructed kidney calyx model

et al. 2018

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During laser lithotripsy, energy is transmitted to both the stone and the surrounding fluid. As the energy is delivered, the temperature will rise. Temperatures ≥60°C can cause protein denaturation. The objective of this study is to determine the time it takes from body temperature (37°C) to 60°C at various laser power settings. A Flexiva TracTip 200 optical fiber was submerged alongside a negative temperature coefficient-type thermistor in 4 mL of saline in a glass test tube. A Lumenis VersaPulse Powersuite 100-W holmium:yttrium aluminum garnet laser was activated at 0.2-to 1.5-J pulse energies, 6-to 50-Hz frequencies, and 2-to 22.5-W average power. Temperature readings were recorded every second from 37°C until 60°C. Time and heating rate were measured. The procedure was repeated three times for each setting. Average time from 37°C to 60°C for settings (1) 0.2 J/50 Hz, (2) 0.6 J/6 Hz, (3) 1 J/10 Hz, and (4) 1.5 J/10 Hz was 60.3, 172.7, 58, and 43.3 s, respectively. Time from 37°C to 60°C decreased as frequency increased for every given pulse energy. Average heating rate increased proportionally to power from 0.06°C/s at 2 W to 0.74°C/ s at 22.5 W. During laser lithotripsy, there is a rapid increase in the temperature of its surrounding fluid and temperatures ≥60°C may be reached. This could have local tissue effects and some caution with higher power settings should be employed especially where irrigation is limited. Further studies incorporating irrigation and live tissue models may aid to further define the risks.

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Section: Looked Atsupporting

confidence: 88%

“…A few recent series have reported on the temperature rise with laser activation. [11][12][13] The objective of this in-vitro study is to determine the time it takes after laser activation to heat fluid from body temperature (37°C) to 60°C at selected laser energy and frequency settings.…”

Section: Introductionmentioning

confidence: 99%

Holmium-YAG laser: impact of pulse energy and frequency on local fluid temperature in an in-vitro obstructed kidney calyx model

et al. 2018

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“…Intrapelvic temperature rises fast when using laser technology at high frequency and energy. This results in alterations of normal cellular functions and cell death . Currently, there is no scientific evidence to support that a UAS provides a cooling effect of the surrounding tissue by increasing irrigation outflow.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of ureteral access sheaths: facts and myths

et al. 2018

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The aim of the present paper was to review the literature on all available ureteral access sheaths (UASs) with their indications, limitations, risks, advantages and disadvantages in current modern endourological practice. Two authors searched Medline, Scopus, Embase and Web of Science databases to identify studies on UASs published in English. No time period restriction was applied. All original articles reporting outcomes or innovations were included. Additional articles identified through references lists were also included. Case reports, editorials, letters, review articles and meeting abstracts were excluded. A total of 754 abstracts were screened, 176 original articles were assessed for eligibility and 83 articles were included in the review. Based on a low level of evidence, UASs increase irrigation flow during flexible ureteroscopy and decrease intrapelvic pressure and probably infectious complications. Data were controversial and sparse on the impact of UASs on multiple reinsertions and withdrawals of a ureteroscope, stone-free rates, ureteroscope protection or damage, postoperative pain, risk of ureteral strictures, and also on its cost-effectiveness. Studies on the benefit of UASs in paediatrics and in patients with a coagulopathy were inconclusive. In the absence of good randomized data, the true impact of UASs on surgery outcome remains unclear. The present review may contribute to the evidence-based decision-making process at the individual patient level regarding whether or not a UAS should be used.

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“…In 2004 Gyrus ACMI introduced the first totally digital flexible ureteroscopic system, the DUR-D Invisio platform [ 2 ]. This was a watershed moment as all the major companies began producing digital flexible ureteroscopes from that moment forward with an improved armamentarium available for the urologist [ 3 ]. In October 2015 Boston Scientific introduced the LithoVue™.…”

Section: Introductionmentioning

confidence: 99%

LithoVue™: A new single-use digital flexible ureteroscope

Butticè

Şener

Netsch

et al. 2016

CEJU

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Temperature Changes Inside the Kidney: What Happens During Holmium:Yttrium-Aluminium-Garnet Laser Usage?

Abstract: Laser use during flexible ureteroscopy may cause increased intrarenal temperatures. Rapid increases should be kept in mind when irrigation is closed. The irrigation seems to limit the temperature increase when used with any laser setting.

Cited by 55 publications

References 31 publications

Holmium-YAG laser: impact of pulse energy and frequency on local fluid temperature in an in-vitro obstructed kidney calyx model

Holmium-YAG laser: impact of pulse energy and frequency on local fluid temperature in an in-vitro obstructed kidney calyx model

Systematic review of ureteral access sheaths: facts and myths

LithoVue™: A new single-use digital flexible ureteroscope

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