Factors Affecting the Irrigation Fluid Temperature During Laser Lithotripsy: In Vitro Experimental Study - 30/11/22

Doi : 10.1016/j.urology.2022.07.060

Angelis Peteinaris ^1,^⁎ , Arman Tsaturyan ¹, Lampros Pantazis ¹, Ergina Farsari ², Begoa Ballesta Martinez ¹, Konstantinos Pagonis ¹, Constantinos Adamou ¹, Athanasios Vagionis ¹, Anastasios Natsos ¹, Evangelos Liatsikos ^1,^3,⁴, Panagiotis Kallidonis ¹
¹ Department of Urology, University of Patras, Patras, Greece
² Plasma Technology Laboratory, Department of Chemical Engineering, University of Patras, Patras, Greece
³ Department of Urology, Medical University of Vienna, Vienna, Austria
⁴ Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia

^⁎Address correspondence to: Angelis Peteinaris, M.D., M.Sc., Department of Urology, University of Patras, Rio, Patras, 26500, Greece.Department of UrologyUniversity of PatrasRioPatras26500Greece

Résumé

OBJECTIVE

To investigate the effect of the diameter of laser fiber, pelvis volume, presence and type of the stone on irrigation fluid temperature rise.

MATERIAL AND METHODS

A 20ml syringe, 12/14 ureteral access sheath(UAS), a dual-lumen catheter and a thermocouple were used. The 12/14Fr UAS(Cook Ireland Ltd., Limerick, Ireland) and the Thermocouple(SE001, Pico Technologies, Cambridgeshire, UK) were inserted in the syringe. The syringe was closed allowing outflow from the UAS with rate at 10ml/min. The Quanta Ho 150W(Quanta System, Samarate, Italy) laser was used and fired with 10W(2Jx5Hz), 20W(2 × 10 Hz), 40W(2 × 20 Hz), 60W(2 × 30 Hz). These power settings were tested in different conditions: fibers(200µm, 365µm and 550µm), volumes(5ml, 10ml and 20ml) and artificial stones(soft, hard). The laser was activated for 30 seconds and reactivation was performed when the temperature reached below 26 °C.

RESULTS

For all trials 60W of energy resulted in higher temperature rise. No differences were observed when different fibers were used. The highest temperatures (up to 80 °C) for 60W were reported in 5ml syringe and the lowest (<45 °C) with 20ml. The maximal temperature of >59°C was recorded for the power of 60W(1Jx60Hz). The temperature exceeded 43 °C when power settings >40W were applied.

CONCLUSION

Increasing the overall power, increases the irrigation fluid temperature significantly. The smaller the volume of the pelvis, the greater the temperature elevation. The fiber size did not affect the temperature increase pattern. The presence of artificial stones was associated with the absorption of energy emitted by the laser.

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