Seguridad, consejos y límites para el uso del láser en la cirugía retrógrada intrarrenal

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas Pub Date : 2024-01-01 DOI:10.1016/j.acuro.2023.04.005

M. Corrales , F. Panthier , C. Solano , L. Candela , O. Traxer

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引用次数: 0

Abstract

Objective

To analyze the current information about laser safety in retrograde intrarenal surgery (RIRS), focusing on the two main laser technologies that we use in urology, the holmium:yttrium-aluminum-garnet (Ho:YAG) laser, and the thulium fiber laser (TFL).

Methods

Narrative overview of the most relevant articles published in Medline and Scopus databases about this subject.

Results

TFL and Ho:YAG laser at similar settings (0.2 J/40 Hz) have similar volume-averaged temperature increase and the average heating rate increase proportionally to laser power, especially when high frequencies are used. Recent preclinical data, comparing both laser technologies at different laser settings, agreed that when the delivered energy increases in expenses of higher frequencies, the thermal damage increases too. Higher frequencies, despite of the rise of temperature in the irrigation medium, can cause accidental thermal lasering lesions.

Conclusions

The use of low frequency settings and a proper irrigation is critical to avoid thermal injury in endoscopic laser lithotripsy (ELL). In addition, the use of laser safety eyeglasses is recommended in Ho:YAG and TFL ELL.

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逆行肾内手术中使用激光的安全性、建议和限制

目的分析逆行肾内手术（RIRS）中激光安全性的现有信息，重点关注我们在泌尿外科使用的两种主要激光技术：钬钇铝石榴石（Ho:YAG）激光和铥光纤激光（TFL）。结果TFL和Ho:YAG激光器在相似的设置（0.2 J/40 Hz）下具有相似的体积平均温升，平均加热率与激光功率成正比增长，尤其是在使用高频率时。最近的临床前数据比较了这两种激光技术在不同激光设置下的效果，结果表明，当输出能量增加、频率提高时，热损伤也随之增加。尽管灌洗介质的温度会升高，但较高的频率也会导致意外的激光热损伤。结论使用低频率设置和适当的灌洗对避免内窥镜激光碎石术（ELL）中的热损伤至关重要。此外，建议在使用 Ho:YAG 和 TFL ELL 时佩戴激光安全眼镜。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Actas urologicas espanolas UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

46 days

期刊介绍： Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.