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Taratkin M, Kovalenko A, Laukhtina E, Paramonova N, Spivak L, Wachtendorf LJ, Eminovic S, Afyouni AS, Okhunov Z, Karagezyan M, Mikhailov V, Strakhov Y, Herrmann TR, Enikeev D. Ex vivo study of Ho:YAG and thulium fiber lasers for soft tissue surgery: which laser for which case? Lasers Med Sci 2020; 37:149-154. [PMID: 33175250 DOI: 10.1007/s10103-020-03189-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 11/04/2020] [Indexed: 12/11/2022]
Abstract
The goal of this study was to assess the ablation, coagulation, and carbonization characteristics of the holmium:YAG (Ho:YAG) laser and thulium fiber lasers (TFL). The Ho:YAG laser (100 W av.power), the quasi-continuous (QCW) TFL (120 W av.power), and the SuperPulsed (SP) TFL (50 W av.power) were compared on a non-frozen porcine kidney. To control the cutting speed (2 or 5 mm/s), an XY translation stage was used. The Ho:YAG was tested using E = 1.5 J and Pav = 40 W or Pav = 70 W settings. The TFL was tested using E = 1.5 J and Pav = 30 W or Pav = 60 W settings. After ex vivo incision, histological analysis was performed in order to estimate thermal damage. At 40 W, the Ho:YAG displayed a shallower cutting at 2 and 5 mm/s (1.1 ± 0.2 mm and 0.5 ± 0.2 mm, respectively) with virtually zero coagulation. While at 70 W, the minimal coagulation depth measured 0.1 ± 0.1 mm. The incisions demonstrated zero carbonization. Both the QCW and SP TFL did show effective cutting at all speeds (2.1 ± 0.2 mm and 1.3 ± 0.2 mm, respectively, at 30 W) with prominent coagulation (0.6 ± 0.1 mm and 0.4 ± 0.1 mm, respectively, at 70 W) and carbonization. Our study introduced the TFL as a novel efficient alternative for soft tissue surgery to the Ho:YAG laser. The SP TFL offers a Ho:YAG-like incision, while QCW TFL allows for fast, deep, and precise cutting with increased carbonization.
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Affiliation(s)
- Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
| | - Anastasia Kovalenko
- NTO "IRE-Polus", One Vvedenskogo Sq, Fryazino, Moscow Region, Russia, 141120
| | - Ekaterina Laukhtina
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Nina Paramonova
- Centralized Pathology Department, Sechenov University, Moscow, Russia
| | - Leonid Spivak
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | | | - Semil Eminovic
- Faculty of Medicine, Philipps University Marburg, Marburg, Germany
| | | | - Zhamshid Okhunov
- Department of Urology, University of California, Irvine, CA, USA
| | - Marina Karagezyan
- Institute of Linguistics and Intercultural Communication, Sechenov University, Moscow, Russia
| | - Vasily Mikhailov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Yuriy Strakhov
- Centralized Pathology Department, Sechenov University, Moscow, Russia
| | - Thomas Rw Herrmann
- Department of Urology, Spital Thurgau AG, Pfaffenholzstrasse 4, 8501, Frauenfeld, Switzerland
- Department of Urology, Hannover Medical School, Hannover, Germany
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
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