Thermal Effects of the Super-Pulse Thulium Fiber Laser During Ureteral Stone Laser Lithotripsy: An In Vivo Porcine Study - Kalon Morgan
August 27, 2022
Kalon Morgan, BS, LIFT Research Fellow, Department of Urology, University of California, Irvine
AUA 2022: Ureteroscopic Thulium Laser Lithotripsy Augmented with a Novel Reverse Thermal Hydrogel in an In-Vivo Porcine Model
Kalon Morgan: My name is Kalon Morgan. I'm an incoming fourth-year medical student at Rocky Vista University. I'm also a Leadership and Innovation Fellowship Training Scholar with the University of California, Irvine, Department of Urology. I'm presenting a project titled Thermal Effects of the Super-Pulse Thulium Fiber Laser During Ureteral Stone Laser Lithotripsy: An In-Vivo Porcine Study.
We assessed intra-ureteral temperature changes during thulium laser lithotripsy and an in-vivo porcine ureter. Three right and three left calcium oxalate ureteral stones were placed. A temperature probe was positioned at the level of each stone. Lithotripsy was done using dusting settings via a 200-micron laser fiber delivered with an 8.5 French ureteroscope. Lithotripsy was stopped whenever temperatures reach 44 degrees Celsius. After 83 seconds, the temperature rose to 44 degrees Celsius. After cessation of lasering, temperature returns to baseline in four seconds. With laser reactivation, the temperature rose to 44 degrees Celsius in six seconds. Histology revealed no acute thermal injury.
In conclusion, thulium laser lithotripsy led to potentially injurious temperature spikes. Use of the thulium laser with brief activation times, interspersed with an equal cool-down period, is recommended. Thank you.