Cargando…

Temperature assessment study of ex vivo holmium laser enucleation of the prostate model

PURPOSE: There isscarce evidence to date on how temperature develops during holmium laser enucleation of the prostate (HoLEP). We aimed to determine the potential heat generation during HoLEP under ex vivo conditions. METHODS: We developed two experimental setups. Firstly, we simulated HoLEP ex vivo...

Descripción completa

Detalles Bibliográficos
Autores principales: Yilmaz, Mehmet, Heuring, Cäcilia Elisabeth Maria, Dressler, Franz Friedrich, Suarez-Ibarrola, Rodrigo, Gratzke, Christian, Miernik, Arkadiusz, Hein, Simon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236967/
https://www.ncbi.nlm.nih.gov/pubmed/35614278
http://dx.doi.org/10.1007/s00345-022-04041-z
_version_ 1784736657720737792
author Yilmaz, Mehmet
Heuring, Cäcilia Elisabeth Maria
Dressler, Franz Friedrich
Suarez-Ibarrola, Rodrigo
Gratzke, Christian
Miernik, Arkadiusz
Hein, Simon
author_facet Yilmaz, Mehmet
Heuring, Cäcilia Elisabeth Maria
Dressler, Franz Friedrich
Suarez-Ibarrola, Rodrigo
Gratzke, Christian
Miernik, Arkadiusz
Hein, Simon
author_sort Yilmaz, Mehmet
collection PubMed
description PURPOSE: There isscarce evidence to date on how temperature develops during holmium laser enucleation of the prostate (HoLEP). We aimed to determine the potential heat generation during HoLEP under ex vivo conditions. METHODS: We developed two experimental setups. Firstly, we simulated HoLEP ex vivo using narrow-neck laboratory bottles mimicking enucleation cavities and a prostate resection trainer. Seven temperature probes were placed at different locations in the experimental setup, and the heat generation was measured separately during laser application. Secondly, we simulated high-frequency current-based coagulation of the vessels using a roller probe. RESULTS: We observed that the larger the enucleated cavity, the higher the temperature rises, regardless of the irrigation flow rate. The highest temperature difference with an irrigation flow was approximately + 4.5 K for a cavity measuring 100ccm and a 300 ml/min irrigation flow rate. The higher flow rate generates faster removal of the generated heat, thus cooling down the artificial cavity. Furthermore, the temperature differences at different irrigation flow rates (except at 0 ml/min) were consistently below 5 K. Within the resection trainer, the temperature increase with and without irrigation flow was approximately 0.5 K and 3.0 K, respectively. The mean depth of necrosis (1084 ± 176 µm) achieved by the roller probe was significantly greater when using 144 W energy. CONCLUSION: Carefully adjusted irrigation and monitoring during HoLEP are crucial when evacuating the thermal energy generated during the procedure. We believe this study of ours provides evidence with the potential to facilitate clinical studies on patient safety. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00345-022-04041-z.
format Online
Article
Text
id pubmed-9236967
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-92369672022-06-29 Temperature assessment study of ex vivo holmium laser enucleation of the prostate model Yilmaz, Mehmet Heuring, Cäcilia Elisabeth Maria Dressler, Franz Friedrich Suarez-Ibarrola, Rodrigo Gratzke, Christian Miernik, Arkadiusz Hein, Simon World J Urol Original Article PURPOSE: There isscarce evidence to date on how temperature develops during holmium laser enucleation of the prostate (HoLEP). We aimed to determine the potential heat generation during HoLEP under ex vivo conditions. METHODS: We developed two experimental setups. Firstly, we simulated HoLEP ex vivo using narrow-neck laboratory bottles mimicking enucleation cavities and a prostate resection trainer. Seven temperature probes were placed at different locations in the experimental setup, and the heat generation was measured separately during laser application. Secondly, we simulated high-frequency current-based coagulation of the vessels using a roller probe. RESULTS: We observed that the larger the enucleated cavity, the higher the temperature rises, regardless of the irrigation flow rate. The highest temperature difference with an irrigation flow was approximately + 4.5 K for a cavity measuring 100ccm and a 300 ml/min irrigation flow rate. The higher flow rate generates faster removal of the generated heat, thus cooling down the artificial cavity. Furthermore, the temperature differences at different irrigation flow rates (except at 0 ml/min) were consistently below 5 K. Within the resection trainer, the temperature increase with and without irrigation flow was approximately 0.5 K and 3.0 K, respectively. The mean depth of necrosis (1084 ± 176 µm) achieved by the roller probe was significantly greater when using 144 W energy. CONCLUSION: Carefully adjusted irrigation and monitoring during HoLEP are crucial when evacuating the thermal energy generated during the procedure. We believe this study of ours provides evidence with the potential to facilitate clinical studies on patient safety. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00345-022-04041-z. Springer Berlin Heidelberg 2022-05-25 2022 /pmc/articles/PMC9236967/ /pubmed/35614278 http://dx.doi.org/10.1007/s00345-022-04041-z Text en © The Author(s) 2022 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
Yilmaz, Mehmet
Heuring, Cäcilia Elisabeth Maria
Dressler, Franz Friedrich
Suarez-Ibarrola, Rodrigo
Gratzke, Christian
Miernik, Arkadiusz
Hein, Simon
Temperature assessment study of ex vivo holmium laser enucleation of the prostate model
title Temperature assessment study of ex vivo holmium laser enucleation of the prostate model
title_full Temperature assessment study of ex vivo holmium laser enucleation of the prostate model
title_fullStr Temperature assessment study of ex vivo holmium laser enucleation of the prostate model
title_full_unstemmed Temperature assessment study of ex vivo holmium laser enucleation of the prostate model
title_short Temperature assessment study of ex vivo holmium laser enucleation of the prostate model
title_sort temperature assessment study of ex vivo holmium laser enucleation of the prostate model
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236967/
https://www.ncbi.nlm.nih.gov/pubmed/35614278
http://dx.doi.org/10.1007/s00345-022-04041-z
work_keys_str_mv AT yilmazmehmet temperatureassessmentstudyofexvivoholmiumlaserenucleationoftheprostatemodel
AT heuringcaciliaelisabethmaria temperatureassessmentstudyofexvivoholmiumlaserenucleationoftheprostatemodel
AT dresslerfranzfriedrich temperatureassessmentstudyofexvivoholmiumlaserenucleationoftheprostatemodel
AT suarezibarrolarodrigo temperatureassessmentstudyofexvivoholmiumlaserenucleationoftheprostatemodel
AT gratzkechristian temperatureassessmentstudyofexvivoholmiumlaserenucleationoftheprostatemodel
AT miernikarkadiusz temperatureassessmentstudyofexvivoholmiumlaserenucleationoftheprostatemodel
AT heinsimon temperatureassessmentstudyofexvivoholmiumlaserenucleationoftheprostatemodel