PD42-05 TEMPERATURE RISE DURING LASER LITHOTRIPSY: COMPARISON OF SUPER PULSE THULIUM FIBER LASER (SPTF) VS HIGH POWER 120W HOLMIUM-YAG LASER (HO:YAG)
Bibliographic record
Abstract
You have accessJournal of UrologyStone Disease: Surgical Therapy IV (PD42)1 Apr 2019PD42-05 TEMPERATURE RISE DURING LASER LITHOTRIPSY: COMPARISON OF SUPER PULSE THULIUM FIBER LASER (SPTF) VS HIGH POWER 120W HOLMIUM-YAG LASER (HO:YAG) Wilson Molina*, Ben Chew, and Bodo Knudsen Wilson Molina*Wilson Molina* More articles by this author , Ben ChewBen Chew More articles by this author , and Bodo KnudsenBodo Knudsen More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556561.54717.f6AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: The holmium-YAG (Ho:YAG) laser system (LS) is the prevailing standard of care for laser lithotripsy (LL). The Super Pulse Thulium Fiber Laser (SPTF) has emerged as an effective alternative. The temperature profiles of 120 W Ho:YAG and a 60 W SPTF LS were evaluated for thermal damage during lithotripsy. METHODS: Anterograde semi-rigid ureteroscopy with LL was performed in ex-vivo porcine urinary tracts with 3 mm Begostones. Room temperature (22°C) saline was instilled using a hand pump for irrigation. Intra-ureteral temperature was measured using one probe proximal and one distal to the site of lithotripsy. LL was performed using a 200 micron core fiber utilizing dusting (SPTF- 0.1J, 200hz, Short Pulse; Ho:YAG- 0.3J, 70hz, Long Pulse) and fragmenting (0.8J, 8Hz, Short Pulse for both) parameters for 5 secs. Fifteen repetitions were recorded for each laser at each setting. Tissue samples of the ureter for each setting and system at each site of lasering were collected for histological analysis. RESULTS: There was a temperature rise for both laser systems at both settings, but was greater at dusting settings; however, both systems remained below the threshold for cellular injury (42°C). The temperatures were greater for the Ho:YAG on the dusting setting (41.13°C vs 40.46°C, p=0.011). On the fragmenting setting, the temperature was greater for the SPTF (31.87°C vs 29.3°C, p=0.001), Fig 1. Histological analysis did not show any signs of injury or necrosis in any of the tested settings. CONCLUSIONS: Higher power settings used for dusting have a higher temperature rise in the ureter during lasering. Ureteral intra-luminal temperature rise during LL was more pronounced on the Ho:YAG during dusting and higher in the SPTF during fragmentation, but neither reached the threshold for thermal injury and are considered safe. Source of Funding: Olympus Corporation of the Americas. Kansas City, KS; Vancouver, Canada; Columbus, OH© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e751-e751 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wilson Molina* More articles by this author Ben Chew More articles by this author Bodo Knudsen More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".