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Initial Clinical Experience with a Modulated Holmium Laser Pulse—Moses Technology: Does It Enhance Laser Lithotripsy Efficacy?

OBJECTIVE: The Lumenis(®) High-power Holmium Laser (120H) has a unique modulated pulse mode, Moses™ technology. Moses technology modulates the laser pulse to separate the water (vapor bubble), then deliver the remaining energy through the bubble. Proprietary laser fibers were designed for the Moses...

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Autores principales: Mullerad, Michael, Aguinaga, Jonatan R. A., Aro, Tareq, Kastin, Alexander, Goldin, Oleg, Kravtsov, Alexander, Assadi, Akram, Badaan, Shadie, Amiel, Gilad E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Rambam Health Care Campus 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652929/
https://www.ncbi.nlm.nih.gov/pubmed/28914602
http://dx.doi.org/10.5041/RMMJ.10315
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author Mullerad, Michael
Aguinaga, Jonatan R. A.
Aro, Tareq
Kastin, Alexander
Goldin, Oleg
Kravtsov, Alexander
Assadi, Akram
Badaan, Shadie
Amiel, Gilad E.
author_facet Mullerad, Michael
Aguinaga, Jonatan R. A.
Aro, Tareq
Kastin, Alexander
Goldin, Oleg
Kravtsov, Alexander
Assadi, Akram
Badaan, Shadie
Amiel, Gilad E.
author_sort Mullerad, Michael
collection PubMed
description OBJECTIVE: The Lumenis(®) High-power Holmium Laser (120H) has a unique modulated pulse mode, Moses™ technology. Moses technology modulates the laser pulse to separate the water (vapor bubble), then deliver the remaining energy through the bubble. Proprietary laser fibers were designed for the Moses technology. Our aim was to compare stone lithotripsy with and without the Moses technology. METHODS: We designed a questionnaire for the urologist to fill immediately after each ureteroscopy in which the Lumenis 120H was used. We compared procedures with (n=23) and without (n=11) the use of Moses technology. Surgeons ranked the Moses technology in 23 procedures, in comparison to regular lithotripsy (worse, equivalent, better, much better). Laser working time and energy use were collected from the Lumenis 120H log. RESULTS: During 4 months, five urologists used the Lumenis 120H in 34 ureteroscopy procedures (19 kidney stones, 15 ureteral stones; 22 procedures with a flexible ureteroscope, and 12 with a semi-rigid ureteroscope). Three urologists ranked Moses technology as much better or better in 17 procedures. In 2 cases, it was ranked equivalent, and in 4 cases ranking was not done. Overall, laser lithotripsy with Moses technology utilized laser energy in less time to achieve a satisfying stone fragmentation rate of 95.8 mm(3)/min versus 58.1 mm(3)/min, P=0.19. However, this did not reach statistical significance. CONCLUSION: The new Moses laser technology demonstrated good stone fragmentation capabilities when used in everyday clinical practice.
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spelling pubmed-56529292017-10-27 Initial Clinical Experience with a Modulated Holmium Laser Pulse—Moses Technology: Does It Enhance Laser Lithotripsy Efficacy? Mullerad, Michael Aguinaga, Jonatan R. A. Aro, Tareq Kastin, Alexander Goldin, Oleg Kravtsov, Alexander Assadi, Akram Badaan, Shadie Amiel, Gilad E. Rambam Maimonides Med J Special Issue on Novel Technologies in Urologic Investigation and Treatment OBJECTIVE: The Lumenis(®) High-power Holmium Laser (120H) has a unique modulated pulse mode, Moses™ technology. Moses technology modulates the laser pulse to separate the water (vapor bubble), then deliver the remaining energy through the bubble. Proprietary laser fibers were designed for the Moses technology. Our aim was to compare stone lithotripsy with and without the Moses technology. METHODS: We designed a questionnaire for the urologist to fill immediately after each ureteroscopy in which the Lumenis 120H was used. We compared procedures with (n=23) and without (n=11) the use of Moses technology. Surgeons ranked the Moses technology in 23 procedures, in comparison to regular lithotripsy (worse, equivalent, better, much better). Laser working time and energy use were collected from the Lumenis 120H log. RESULTS: During 4 months, five urologists used the Lumenis 120H in 34 ureteroscopy procedures (19 kidney stones, 15 ureteral stones; 22 procedures with a flexible ureteroscope, and 12 with a semi-rigid ureteroscope). Three urologists ranked Moses technology as much better or better in 17 procedures. In 2 cases, it was ranked equivalent, and in 4 cases ranking was not done. Overall, laser lithotripsy with Moses technology utilized laser energy in less time to achieve a satisfying stone fragmentation rate of 95.8 mm(3)/min versus 58.1 mm(3)/min, P=0.19. However, this did not reach statistical significance. CONCLUSION: The new Moses laser technology demonstrated good stone fragmentation capabilities when used in everyday clinical practice. Rambam Health Care Campus 2017-10-16 /pmc/articles/PMC5652929/ /pubmed/28914602 http://dx.doi.org/10.5041/RMMJ.10315 Text en Copyright: © 2017 Mullerad et al. This is an open-access article. All its content, except where otherwise noted, is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Special Issue on Novel Technologies in Urologic Investigation and Treatment
Mullerad, Michael
Aguinaga, Jonatan R. A.
Aro, Tareq
Kastin, Alexander
Goldin, Oleg
Kravtsov, Alexander
Assadi, Akram
Badaan, Shadie
Amiel, Gilad E.
Initial Clinical Experience with a Modulated Holmium Laser Pulse—Moses Technology: Does It Enhance Laser Lithotripsy Efficacy?
title Initial Clinical Experience with a Modulated Holmium Laser Pulse—Moses Technology: Does It Enhance Laser Lithotripsy Efficacy?
title_full Initial Clinical Experience with a Modulated Holmium Laser Pulse—Moses Technology: Does It Enhance Laser Lithotripsy Efficacy?
title_fullStr Initial Clinical Experience with a Modulated Holmium Laser Pulse—Moses Technology: Does It Enhance Laser Lithotripsy Efficacy?
title_full_unstemmed Initial Clinical Experience with a Modulated Holmium Laser Pulse—Moses Technology: Does It Enhance Laser Lithotripsy Efficacy?
title_short Initial Clinical Experience with a Modulated Holmium Laser Pulse—Moses Technology: Does It Enhance Laser Lithotripsy Efficacy?
title_sort initial clinical experience with a modulated holmium laser pulse—moses technology: does it enhance laser lithotripsy efficacy?
topic Special Issue on Novel Technologies in Urologic Investigation and Treatment
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652929/
https://www.ncbi.nlm.nih.gov/pubmed/28914602
http://dx.doi.org/10.5041/RMMJ.10315
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