Abstract：
BACKGROUND: Endocorporeal laser lithotripsy (EL) during flexible ureteroscopy (URS-f) often uses \"dusting\" settings with \"painting\" technique. The displacement velocity of the laser fiber (LF) at the stone surface remains unknown and could improve EL\'s ablation rates. This in vitro study aimed to define the optimal displacement velocity (ODV) for both holmium:yttrium-aluminium-garnet (Ho:YAG) and thulium fiber laser (Tm-Fiber).
METHODS: A 50W-TFL (IRE Polus®, Moscow, Russia) and a 30W-MH1-Ho:YAG laser (Rocamed®, Signes, Provence-Alpes-Côte d\'Azur, France), were used with 272 µm-Core-Diameter LF (Sureflex, Boston Scientific©, San Jose, CA, USA), comparing three TFL modes, \"fine dusting\" (FD: 0.05-0.15 J/100-600 Hz); \"dusting\" (D: 0.5 J/30-60 Hz); \"fragmentation\" (Fr: 1 J/15-30 Hz) and two Ho:YAG modes (D: 0.5 J/20 Hz, Fr: 1 J/15 Hz). An experimental setup consisting of immerged cubes of calcium oxalate monohydrate (COM) stone phantoms (Begostone Plus, Bego©, Lincoln, RI, USA) was used with a 2 s\' laser operation time. LF were in contact with the stones, static or with a displacement of 5, 10 or 20 mm. Experiments were repeated four times. Stones were dried and µ-scanned. Ablation volumes (mm3) were measured by 3D-segmentation.
RESULTS: ODV was higher in dusting compared to fragmentation mode during Ho:YAG lithotripsy (10 mm/s vs. 5 mm/s, respectively). With Tm-Fiber, dusting and fragmentation OVDs were similar (5 mm/s). Tm-Fiber ODV was lower than Ho:YAGs in dusting settings (5 mm/s vs. 10 mm/s, respectively). Without LF displacement, ablation volumes were at least two-fold higher with Tm-Fiber compared to Ho:YAG. Despite the LF-DV, we report a 1.5 to 5-fold higher ablation volume with Tm-Fiber compared to Ho:YAG.
CONCLUSIONS: In dusting mode, the ODVTm-Fiber is lower compared to ODVHo:YAG, translating to a potential easier Tm-Fiber utilization for \"painting\" dusting technique. The ODV determinants remain unknown. Dynamic ablation volumes are higher to static ones, regardless of the laser source, settings or LF displacement velocity.
METHODS: A 50W-TFL (IRE Polus®, Moscow, Russia) and a 30W-MH1-Ho:YAG laser (Rocamed®, Signes, Provence-Alpes-Côte d\'Azur, France), were used with 272 µm-Core-Diameter LF (Sureflex, Boston Scientific©, San Jose, CA, USA), comparing three TFL modes, \"fine dusting\" (FD: 0.05-0.15 J/100-600 Hz); \"dusting\" (D: 0.5 J/30-60 Hz); \"fragmentation\" (Fr: 1 J/15-30 Hz) and two Ho:YAG modes (D: 0.5 J/20 Hz, Fr: 1 J/15 Hz). An experimental setup consisting of immerged cubes of calcium oxalate monohydrate (COM) stone phantoms (Begostone Plus, Bego©, Lincoln, RI, USA) was used with a 2 s\' laser operation time. LF were in contact with the stones, static or with a displacement of 5, 10 or 20 mm. Experiments were repeated four times. Stones were dried and µ-scanned. Ablation volumes (mm3) were measured by 3D-segmentation.
RESULTS: ODV was higher in dusting compared to fragmentation mode during Ho:YAG lithotripsy (10 mm/s vs. 5 mm/s, respectively). With Tm-Fiber, dusting and fragmentation OVDs were similar (5 mm/s). Tm-Fiber ODV was lower than Ho:YAGs in dusting settings (5 mm/s vs. 10 mm/s, respectively). Without LF displacement, ablation volumes were at least two-fold higher with Tm-Fiber compared to Ho:YAG. Despite the LF-DV, we report a 1.5 to 5-fold higher ablation volume with Tm-Fiber compared to Ho:YAG.
CONCLUSIONS: In dusting mode, the ODVTm-Fiber is lower compared to ODVHo:YAG, translating to a potential easier Tm-Fiber utilization for \"painting\" dusting technique. The ODV determinants remain unknown. Dynamic ablation volumes are higher to static ones, regardless of the laser source, settings or LF displacement velocity.
摘要：
背景：输尿管软镜（URS-f）中的体内激光碎石术（EL）通常使用带有“涂漆”技术的“除尘”设置。激光光纤（LF）在石材表面的位移速度仍然未知，可以提高EL的烧蚀率。这项体外研究旨在确定钬：钇-铝-石榴石（Ho：YAG）和the光纤激光器（Tm-Fiber）的最佳位移速度（ODV）。
方法：A50W-TFL（IREPolus®，莫斯科,俄罗斯）和30W-MH1-Ho：YAG激光器（Rocamed®，迹象,普罗旺斯-阿尔卑斯-蔚蓝海岸,法国),与272μm核心直径LF一起使用(反射，波士顿科学©，圣何塞,CA,美国),比较三种TFL模式，\“精细除尘\”（FD：0.05-0.15J/100-600Hz）；\“除尘\”（D：0.5J/30-60Hz）；\“碎片\”（Fr：1J/15-30Hz）和两种Ho：YAG模式（D：0.5J/20Hz，Fr:1J/15Hz)。由浸入的一水合草酸钙（COM）石模立方体组成的实验装置（BegosonePlus，Bego©,林肯,RI,美国）的激光手术时间为2s。LF与石头接触，静态或位移5，10或20毫米。实验重复四次。将石头干燥并µ扫描。通过3D分割测量消融体积(mm3)。
结果：在Ho：YAG碎石术中，与碎裂模式相比，喷粉中的ODV更高（10mm/s与5mm/s,分别)。使用Tm-Fiber，粉尘和碎裂OVD相似(5mm/s)。在除尘设置中，Tm-FiberODV低于Ho：YAG（5mm/s与10mm/s,分别)。没有LF位移，与Ho:YAG相比,Tm-Fiber的消融体积至少高2倍.尽管有LF-DV,我们报告了与Ho:YAG相比，Tm-Fiber的消融体积高1.5至5倍。
结论：在除尘模式下，与ODVHo：YAG相比，ODVTm-Fiber更低，转化为“绘画”除尘技术的潜在更容易的Tm-纤维利用率。ODV决定因素仍然未知。动态消融体积高于静态消融体积,不管激光源，设置或LF位移速度。
方法：A50W-TFL（IREPolus®，莫斯科,俄罗斯）和30W-MH1-Ho：YAG激光器（Rocamed®，迹象,普罗旺斯-阿尔卑斯-蔚蓝海岸,法国),与272μm核心直径LF一起使用(反射，波士顿科学©，圣何塞,CA,美国),比较三种TFL模式，\“精细除尘\”（FD：0.05-0.15J/100-600Hz）；\“除尘\”（D：0.5J/30-60Hz）；\“碎片\”（Fr：1J/15-30Hz）和两种Ho：YAG模式（D：0.5J/20Hz，Fr:1J/15Hz)。由浸入的一水合草酸钙（COM）石模立方体组成的实验装置（BegosonePlus，Bego©,林肯,RI,美国）的激光手术时间为2s。LF与石头接触，静态或位移5，10或20毫米。实验重复四次。将石头干燥并µ扫描。通过3D分割测量消融体积(mm3)。
结果：在Ho：YAG碎石术中，与碎裂模式相比，喷粉中的ODV更高（10mm/s与5mm/s,分别)。使用Tm-Fiber，粉尘和碎裂OVD相似(5mm/s)。在除尘设置中，Tm-FiberODV低于Ho：YAG（5mm/s与10mm/s,分别)。没有LF位移，与Ho:YAG相比,Tm-Fiber的消融体积至少高2倍.尽管有LF-DV,我们报告了与Ho:YAG相比，Tm-Fiber的消融体积高1.5至5倍。
结论：在除尘模式下，与ODVHo：YAG相比，ODVTm-Fiber更低，转化为“绘画”除尘技术的潜在更容易的Tm-纤维利用率。ODV决定因素仍然未知。动态消融体积高于静态消融体积,不管激光源，设置或LF位移速度。
