A method for reducing thermal injury during the ureteroscopic holmium laser lithotripsy
Objective: Many studies have demonstrated the heat effect from the holmium laser lithotripsy can cause persistent thermal injury to the ureter. The purpose of this study was to elucidate the use of a modified ureteral catheter with appropriate firing and irrigation to reduce the thermal injury to th...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-01-01
|
| Series: | Asian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388222001126 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849322813035380736 |
|---|---|
| author | Xiaoliang Zhu Feiping Li Xixi Hu Haiping Li Songjiang Wu Haihong Jiang |
| author_facet | Xiaoliang Zhu Feiping Li Xixi Hu Haiping Li Songjiang Wu Haihong Jiang |
| author_sort | Xiaoliang Zhu |
| collection | DOAJ |
| description | Objective: Many studies have demonstrated the heat effect from the holmium laser lithotripsy can cause persistent thermal injury to the ureter. The purpose of this study was to elucidate the use of a modified ureteral catheter with appropriate firing and irrigation to reduce the thermal injury to the “ureter” during the ureteroscopic holmium laser lithotripsy in vitro. Methods: An in vitro lithotripsy was performed using a modified catheter (5 Fr) as the entrance for the irrigation and the holmium laser fiber while using the remaining space in the ureteroscopic channel as an outlet. Different laser power settings (10 W, 20 W, and 30 W) with various firing times (3 s, 5 s, and 10 s) and rates of irrigation (15 mL/min, 20 mL/min, and 30 mL/min) were applied in the experiment. Temperature changes in the “ureter” were recorded with a thermometer during and after the lithotripsy. Results: During the lithotripsy, the local highest mean temperature was 60.3 °C and the lowest mean temperature was 26.7 °C. When the power was set to 10 w, the temperature was maintained below 43 °C regardless of laser firing time or irrigation flow. Regardless of the power or firing time selected, the temperature was below 43 °C at the rate of 30 mL/min. There was a significant difference in temperature decrease when continuous 3 s drainage after continuous firing (3 s, 5 s, or 10 s) compared to with not drainage (p<0.05) except for two conditions of 0.5 J×20 Hz, 30 mL/min, firing 5 s, and 1.0 J×10 Hz, 30 mL/min, firing 5 s. Conclusion: Our modified catheter with timely drainage reducing hot irrigation may significantly reduce the local thermal injury effect, especially along with the special interrupted-time firing setting during the simulated holmium laser procedure. |
| format | Article |
| id | doaj-art-da32d277b07b4330be9710e863f1e217 |
| institution | Kabale University |
| issn | 2214-3882 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj-art-da32d277b07b4330be9710e863f1e2172025-08-20T03:49:16ZengElsevierAsian Journal of Urology2214-38822023-01-01101899510.1016/j.ajur.2022.05.011A method for reducing thermal injury during the ureteroscopic holmium laser lithotripsyXiaoliang Zhu0Feiping Li1Xixi Hu2Haiping Li3Songjiang Wu4Haihong Jiang5Department of Urology and Andrology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China; Department of Urology and Andrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Urology and Andrology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, ChinaDepartment of Urology and Andrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Urology and Andrology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, ChinaDepartment of Urology and Andrology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, ChinaDepartment of Urology and Andrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Corresponding author.Objective: Many studies have demonstrated the heat effect from the holmium laser lithotripsy can cause persistent thermal injury to the ureter. The purpose of this study was to elucidate the use of a modified ureteral catheter with appropriate firing and irrigation to reduce the thermal injury to the “ureter” during the ureteroscopic holmium laser lithotripsy in vitro. Methods: An in vitro lithotripsy was performed using a modified catheter (5 Fr) as the entrance for the irrigation and the holmium laser fiber while using the remaining space in the ureteroscopic channel as an outlet. Different laser power settings (10 W, 20 W, and 30 W) with various firing times (3 s, 5 s, and 10 s) and rates of irrigation (15 mL/min, 20 mL/min, and 30 mL/min) were applied in the experiment. Temperature changes in the “ureter” were recorded with a thermometer during and after the lithotripsy. Results: During the lithotripsy, the local highest mean temperature was 60.3 °C and the lowest mean temperature was 26.7 °C. When the power was set to 10 w, the temperature was maintained below 43 °C regardless of laser firing time or irrigation flow. Regardless of the power or firing time selected, the temperature was below 43 °C at the rate of 30 mL/min. There was a significant difference in temperature decrease when continuous 3 s drainage after continuous firing (3 s, 5 s, or 10 s) compared to with not drainage (p<0.05) except for two conditions of 0.5 J×20 Hz, 30 mL/min, firing 5 s, and 1.0 J×10 Hz, 30 mL/min, firing 5 s. Conclusion: Our modified catheter with timely drainage reducing hot irrigation may significantly reduce the local thermal injury effect, especially along with the special interrupted-time firing setting during the simulated holmium laser procedure.http://www.sciencedirect.com/science/article/pii/S2214388222001126Modified catheterHolmium laserLithotripsyThermal injury |
| spellingShingle | Xiaoliang Zhu Feiping Li Xixi Hu Haiping Li Songjiang Wu Haihong Jiang A method for reducing thermal injury during the ureteroscopic holmium laser lithotripsy Asian Journal of Urology Modified catheter Holmium laser Lithotripsy Thermal injury |
| title | A method for reducing thermal injury during the ureteroscopic holmium laser lithotripsy |
| title_full | A method for reducing thermal injury during the ureteroscopic holmium laser lithotripsy |
| title_fullStr | A method for reducing thermal injury during the ureteroscopic holmium laser lithotripsy |
| title_full_unstemmed | A method for reducing thermal injury during the ureteroscopic holmium laser lithotripsy |
| title_short | A method for reducing thermal injury during the ureteroscopic holmium laser lithotripsy |
| title_sort | method for reducing thermal injury during the ureteroscopic holmium laser lithotripsy |
| topic | Modified catheter Holmium laser Lithotripsy Thermal injury |
| url | http://www.sciencedirect.com/science/article/pii/S2214388222001126 |
| work_keys_str_mv | AT xiaoliangzhu amethodforreducingthermalinjuryduringtheureteroscopicholmiumlaserlithotripsy AT feipingli amethodforreducingthermalinjuryduringtheureteroscopicholmiumlaserlithotripsy AT xixihu amethodforreducingthermalinjuryduringtheureteroscopicholmiumlaserlithotripsy AT haipingli amethodforreducingthermalinjuryduringtheureteroscopicholmiumlaserlithotripsy AT songjiangwu amethodforreducingthermalinjuryduringtheureteroscopicholmiumlaserlithotripsy AT haihongjiang amethodforreducingthermalinjuryduringtheureteroscopicholmiumlaserlithotripsy AT xiaoliangzhu methodforreducingthermalinjuryduringtheureteroscopicholmiumlaserlithotripsy AT feipingli methodforreducingthermalinjuryduringtheureteroscopicholmiumlaserlithotripsy AT xixihu methodforreducingthermalinjuryduringtheureteroscopicholmiumlaserlithotripsy AT haipingli methodforreducingthermalinjuryduringtheureteroscopicholmiumlaserlithotripsy AT songjiangwu methodforreducingthermalinjuryduringtheureteroscopicholmiumlaserlithotripsy AT haihongjiang methodforreducingthermalinjuryduringtheureteroscopicholmiumlaserlithotripsy |