MP79-19 COMPARISON OF DUSTING AND FRAGMENTING USING THE NEW SUPER PULSE THULIUM FIBER LASER TO A 120W HOLMIUM:YAG LASER
Bibliographic record
Abstract
You have accessJournal of UrologyStone Disease: Surgical Therapy VI (MP79)1 Apr 2019MP79-19 COMPARISON OF DUSTING AND FRAGMENTING USING THE NEW SUPER PULSE THULIUM FIBER LASER TO A 120W HOLMIUM:YAG LASER Ben H. Chew*, Bodo E. Knudsen, and Wilson R. Molina Ben H. Chew*Ben H. Chew* More articles by this author , Bodo E. KnudsenBodo E. Knudsen More articles by this author , and Wilson R. MolinaWilson R. Molina More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000557398.56442.e8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Holmium:YAG laser is the current lithotrite of choice. Although improvements such as higher pulse frequency, longer pulse duration, and multi-pulse technology have advanced the platform, inherent limitations remain include high amperage power requirements, upper limits of pulse frequency, and limitations regarding fiber size. A new technology utilizing Thulium Fiber, which is completely different from Thulium:YAG, offers low pulse energy settings and pulse frequencies over 600Hz. We compared the novel Super Pulse Thulium Fiber laser (SPTF) to a commercially available 120W Ho:YAG laser. METHODS: Standard, homogeneous 5mm3 Begostones were used for all testing (n=10). To test ablation, stones were reduced using a commercially available 120W laser vs the SPTF laser until remaining particles were <1 mm. To test fragmentation and dusting, resulting particle sizes were measured after delivering a total of 0.5 kJ and 2kJ, respectively. RESULTS: Ablation to particles <1 mm was significantly faster using the SPTFL laser 2.23±0.22 mg/s (0.6J 30Hz SP) compared to the 120W laser 1.78± 0.44 mg/s (0.8J 10Hz SP), p=0.01 (Fig 1). After delivering 0.5kJ, fewer particles >2mm remained for SPTF than for the 120W laser (2.1 vs 7.2 fragments). Clinically, this would equate to fewer basketing passes for SPTF. The dusting rate (1.05± 0.08 mg/s) was significantly faster using SPTF (0.1J 200Hz SP) compared to 120W 0.46±0.09 mg/s (0.3J 70Hz Moses), p<0.001 (Fig 1). After delivering 2kJ, the SPTFL (0.1J 200Hz) produced 40% dust < 0.5mm compared to 24% produced by the 120W laser at 0.3J 70Hz Moses and 14% at 0.3J 70Hz LP, p<0.005 (Fig 2). CONCLUSIONS: The new Super Pulse Thulium Fiber laser is more efficacious in bench testing than a commercially available 120W laser in fragmenting and dusting stones. In tests of particle sizes, it produced smaller particles of dust. Fragmentation produced fewer fragments using SPTF (and more dust), thus making basketing more efficient. Source of Funding: The Authoring Physicians are paid consultants to Olympus Corporation of the Americas. Vancouver, Canada; Columbus, OH; Lawrence, KS© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e1159-e1160 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ben H. Chew* More articles by this author Bodo E. Knudsen More articles by this author Wilson R. Molina 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 | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
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".