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Thermal effects of thulium: YAG laser treatment of the prostate—an in vitro study

PURPOSE: To objectively determine whether there is potential thermal tissue damage during Tm:YAG laser-based LUTS treatment. METHODS: Our experimental model was comprised of a prostatic resection trainer placed in a 37 °C water bath. In a hollowed-out central area simulating the urethral lumen, we p...

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Autores principales: Hein, Simon, Petzold, Ralf, Suarez-Ibarrola, Rodrigo, Schoenthaler, Martin, Gratzke, Christian, Miernik, Arkadiusz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8813676/
https://www.ncbi.nlm.nih.gov/pubmed/34476596
http://dx.doi.org/10.1007/s00345-021-03805-3
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author Hein, Simon
Petzold, Ralf
Suarez-Ibarrola, Rodrigo
Schoenthaler, Martin
Gratzke, Christian
Miernik, Arkadiusz
author_facet Hein, Simon
Petzold, Ralf
Suarez-Ibarrola, Rodrigo
Schoenthaler, Martin
Gratzke, Christian
Miernik, Arkadiusz
author_sort Hein, Simon
collection PubMed
description PURPOSE: To objectively determine whether there is potential thermal tissue damage during Tm:YAG laser-based LUTS treatment. METHODS: Our experimental model was comprised of a prostatic resection trainer placed in a 37 °C water bath. In a hollowed-out central area simulating the urethral lumen, we placed a RigiFib 800 fibre, irrigation inflow regulated with a digital pump, and a type K thermocouple. A second thermocouple was inserted 0.5/1 cm adjacently and protected with an aluminum barrier to prevent it from urethral fluid. We investigated continuous and intermittent 120 W and 80 W laser application with various irrigation rates in eight measurement sessions lasting up to 14 min. Thermal measurements were recorded continuously and in real-time using MatLab. All experiments were repeated five times to balance out variations. RESULTS: Continuous laser application at 120 W and 125 ml/min caused a urethral ∆T of ~ 15 K and a parenchymal temperature increase of up to 7 K. With 50 ml/min irrigation, a urethral and parenchymal ∆T of 30 K and 15 K were reached, respectively. Subsequently and in absence of laser application, prostatic parenchyma needed over 16 min to reach baseline body temperature. At 80 W lower temperature increases were reached compared to similar irrigation but higher power. CONCLUSIONS: We showed that potentially harming temperatures can be reached, especially during high laser power and low irrigation. The heat generation can also be conveyed to the prostate parenchyma and deeper structures, potentially affecting the neurovascular bundles. Further clinical studies with intracorporal temperature measurement are necessary to further investigate this potentially harming surgical adverse effect.
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spelling pubmed-88136762022-02-23 Thermal effects of thulium: YAG laser treatment of the prostate—an in vitro study Hein, Simon Petzold, Ralf Suarez-Ibarrola, Rodrigo Schoenthaler, Martin Gratzke, Christian Miernik, Arkadiusz World J Urol Original Article PURPOSE: To objectively determine whether there is potential thermal tissue damage during Tm:YAG laser-based LUTS treatment. METHODS: Our experimental model was comprised of a prostatic resection trainer placed in a 37 °C water bath. In a hollowed-out central area simulating the urethral lumen, we placed a RigiFib 800 fibre, irrigation inflow regulated with a digital pump, and a type K thermocouple. A second thermocouple was inserted 0.5/1 cm adjacently and protected with an aluminum barrier to prevent it from urethral fluid. We investigated continuous and intermittent 120 W and 80 W laser application with various irrigation rates in eight measurement sessions lasting up to 14 min. Thermal measurements were recorded continuously and in real-time using MatLab. All experiments were repeated five times to balance out variations. RESULTS: Continuous laser application at 120 W and 125 ml/min caused a urethral ∆T of ~ 15 K and a parenchymal temperature increase of up to 7 K. With 50 ml/min irrigation, a urethral and parenchymal ∆T of 30 K and 15 K were reached, respectively. Subsequently and in absence of laser application, prostatic parenchyma needed over 16 min to reach baseline body temperature. At 80 W lower temperature increases were reached compared to similar irrigation but higher power. CONCLUSIONS: We showed that potentially harming temperatures can be reached, especially during high laser power and low irrigation. The heat generation can also be conveyed to the prostate parenchyma and deeper structures, potentially affecting the neurovascular bundles. Further clinical studies with intracorporal temperature measurement are necessary to further investigate this potentially harming surgical adverse effect. Springer Berlin Heidelberg 2021-09-02 2022 /pmc/articles/PMC8813676/ /pubmed/34476596 http://dx.doi.org/10.1007/s00345-021-03805-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Hein, Simon
Petzold, Ralf
Suarez-Ibarrola, Rodrigo
Schoenthaler, Martin
Gratzke, Christian
Miernik, Arkadiusz
Thermal effects of thulium: YAG laser treatment of the prostate—an in vitro study
title Thermal effects of thulium: YAG laser treatment of the prostate—an in vitro study
title_full Thermal effects of thulium: YAG laser treatment of the prostate—an in vitro study
title_fullStr Thermal effects of thulium: YAG laser treatment of the prostate—an in vitro study
title_full_unstemmed Thermal effects of thulium: YAG laser treatment of the prostate—an in vitro study
title_short Thermal effects of thulium: YAG laser treatment of the prostate—an in vitro study
title_sort thermal effects of thulium: yag laser treatment of the prostate—an in vitro study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8813676/
https://www.ncbi.nlm.nih.gov/pubmed/34476596
http://dx.doi.org/10.1007/s00345-021-03805-3
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