Gallentine M L, Bishoff J T, Harmon W J
Wilford Hall Medical Center, Lackland Air Force Base, TX 78236-5300, USA.
J Endourol. 2001 Nov;15(9):911-4. doi: 10.1089/089277901753284125.
We investigated the ease of breakage of endoscopic stone baskets with the holmium:yttrium-aluminum-garnet (YAG) laser and their resultant configuration. More importantly, possible safe methods of retrieval were evaluated.
Endoscopic stone baskets from Bard (Platinum Class 2.4F Flat and 3.0F Helical Wire), Cook (3.2F Captura, 3.2F Atlas, 3.0F N-Circle, 4.5F N-Force), and Microvasive (2.4F Zero Tip, 3.0F Gemini, 3.0F Segura) were broken once using the holmium:YAG laser. The energy (kJ) required to break one of the wires was recorded. Configuration was documented using photographs. Baskets were disassembled and assessed for extraction through a 7F open-ended catheter, an 8F/10F set, and a 20F peel-away sheath.
Tipless baskets (N-Circle, Zero Tip) broke the easiest (range 0.02-0.03 kJ). Tipped baskets (Segura, Platinum Class Flat and Helical, Gemini, Captura, N-Force, Atlas) were more resistant, but all broke within the range (0.06-0.78 kJ) typically used for intracorporeal lithotripsy. Broken segments of wire tended to protrude outward, with tipless baskets having less change in configuration than tipped baskets. Tipless baskets could easily be pulled into any of the extracting devices, whereas tipped baskets could not.
Baskets break at typical holmium:YAG intracorporeal lithotripsy energy settings. Tipless baskets break easiest and assume a safer configuration. Tipless baskets are extracted easily through a 7F open-ended catheter, 8F/10F set, or 20F sheath, while tipped baskets are unable to be extracted through any of these.
我们研究了钬：钇铝石榴石（YAG）激光对内窥镜取石篮的破坏难易程度及其最终形态。更重要的是，评估了可能的安全取出方法。
使用钬：YAG激光分别对巴德公司（铂类2.4F扁平型和3.0F螺旋型）、库克公司（3.2F Captura、3.2F Atlas、3.0F N-Circle、4.5F N-Force）以及微创公司（2.4F零头端型、3.0F Gemini、3.0F Segura）的内镜取石篮进行一次破坏。记录破坏一根金属丝所需的能量（千焦）。通过拍照记录形态。将取石篮拆解，并评估其能否通过7F开口导管、8F/10F套装以及20F可剥离鞘管取出。
无尖端取石篮（N-Circle、零头端型）最易被破坏（范围为0.02 - 0.03千焦）。有尖端取石篮（Segura、铂类扁平型和螺旋型、Gemini、Captura、N-Force、Atlas）更具抗性，但在通常用于体内碎石的能量范围内（0.06 - 0.78千焦）均会被破坏。金属丝的断裂段往往向外突出，无尖端取石篮的形态变化比有尖端取石篮小。无尖端取石篮可轻松被拉入任何一种取出装置，而有尖端取石篮则不能。
在典型的钬：YAG体内碎石能量设置下，取石篮会被破坏。无尖端取石篮最易被破坏且形态更安全。无尖端取石篮可轻松通过7F开口导管、8F/10F套装或20F鞘管取出，而有尖端取石篮无法通过上述任何一种装置取出。
