Turning up the HEAT: Surgical simulation of the Moses 2.0 laser in an anatomic model

Authors

  • Christopher Wanderling University of Rochester Medical Center
  • Aaron Saxton University of Rochester
  • Dennis Phan University of Rochester
  • Karen Doersch
  • Lauren Shepard Johns Hopkins University
  • Nathan Schuler Johns Hopkins University
  • Thomas Osinski University of Rochester
  • Scott Quarrier University of Rochester
  • Ahmed Ghazi University of Rochester

DOI:

https://doi.org/10.5489/cuaj.8673

Keywords:

Thermal Dose, Temperature, Laser Lithotripsy, Holmium, Anatomic Model

Abstract

Introduction: With advancements in laser technology, urologists have been able to treat urinary calculi more efficiently by increasing the energy delivered to the stone. With increases in power used, there is an increase in temperatures generated during laser lithotripsy. The aim of this study was to evaluate the thermal dose and temperatures generated with four laser settings at a standardized power in a high-fidelity, anatomic model.

Methods: Using high-fidelity, 3D printed hydrogel models of a pelvicalyceal collecting system with a synthetic BegoStone implanted in the renal pelvis, surgical simulation of ureteroscopic laser lithotripsy was performed with the Moses 2.0 holmium laser. At a standard power (40 W) and irrigation pressure (100 cm H2O), we evaluated operator duty cycle (ODC) variations with different time-on intervals at four different laser settings. Temperature was measured at two separate locations: at the stone and ureteropelvic junction.

Results: Greater cumulative thermal doses and maximal temperatures were achieved with greater ODCs and longer laser activation periods. There were statistically significant differences between the thermal doses and temperature profiles of the laser settings evaluated. Temperatures were greater closer to the tip of the laser fiber.

Conclusions: Laser energy and frequency play an important role in the thermal loads delivered during laser lithotripsy. Urologists must perform laser lithotripsy cautiously when aggressively treating large renal pelvis stones, as dangerous temperatures can be reached. To reduce the risk of causing thermal tissue injury, urologists should consider reducing their ODC and laser-on time.

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Published

2024-03-01

How to Cite

Wanderling, C., Saxton, A., Phan, D., Doersch, K., Shepard, L., Schuler, N., Osinski, T., Quarrier, S., & Ghazi, A. (2024). Turning up the HEAT: Surgical simulation of the Moses 2.0 laser in an anatomic model . Canadian Urological Association Journal, 18(7). https://doi.org/10.5489/cuaj.8673

Issue

Vol. 18 No. 7 (2024): CUAJ July

Section

Original Research

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