Kallidonis Panagiotis, Kamal Wissam, Panagopoulos Vasileios, Vasilas Marinos, Amanatides Lefteris, Kyriazis Iason, Vrettos Theofanis, Fligou Fotini, Liatsikos Evangelos
1 Department of Urology, University of Patras , Patras, Greece .
2 Department of Chemical Engineering, University of Patras , Patras, Greece .
J Endourol. 2016 May;30(5):555-9. doi: 10.1089/end.2015.0768. Epub 2016 Feb 4.
The current experimental study aimed at evaluating the temperature raise of the irrigation fluid caused by the use of the thulium (Tm:YAG) and holmium laser (Ho:YAG) in the upper urinary tract (UT) of pigs.
An experimental setting was designed for the investigation of differences in the temperature of the irrigation fluid in the renal pelvis of a porcine model under different flow rates and laser power settings. The experimental configuration included a single-use flexible ureteroscope, a Tm:YAG and a Ho:YAG laser system. A thermocouple was inserted through a 6F ureteral catheter that was placed parallel to the FlexVue in the renal pelvis. An additional thermocouple was placed next to the renal pelvis after open preparation of the kidney. Irrigation was achieved with either the irrigation bags placed 1 m above the level of the pig or with the use of an irrigation pump (30 and 60 compressions per minute).
Tm:YAG (10, 20, 30, 40 W): The higher flow provided by the pump system minimized the increase of temperature within the renal pelvis regardless of the laser power. The external temperature increase was lower in comparison to the increase inside the renal pelvis. The internal temperature could increase up to 10.5°C from a baseline value of 23°C. Ho:YAG (10, 20 W): There was no temperature change or an increase of only 2.1°C under the different power and irrigation flow rate settings. There were no differences in the temperature between the inside and outside of the renal pelvis.
The use of Tm:YAG in continuous mode with power settings up to 40 W and flow rates similar to those used in the clinical practice seemed to result in temperature increases in the irrigation fluid, which do not represent a risk for the renal tissue during the UT endoscopic surgery.
当前的实验研究旨在评估在猪的上尿路（UT）中使用铥激光（Tm:YAG）和钬激光（Ho:YAG）导致的冲洗液温度升高情况。
设计了一个实验装置，用于研究在不同流速和激光功率设置下猪模型肾盂内冲洗液温度的差异。实验配置包括一次性使用的软性输尿管镜、Tm:YAG和Ho:YAG激光系统。通过一根6F输尿管导管插入一个热电偶，该导管与肾盂内的FlexVue平行放置。在肾脏开放准备后，在肾盂旁边放置另一个热电偶。使用放置在猪体水平上方1米处的冲洗袋或使用冲洗泵（每分钟30和60次按压）进行冲洗。
Tm:YAG（10、20、30、40瓦）：无论激光功率如何，泵系统提供的较高流速使肾盂内温度升高最小化。与肾盂内部的升高相比，外部温度升高较低。内部温度可从23°C的基线值升高至10.5°C。Ho:YAG（10、20瓦）：在不同功率和冲洗流速设置下，温度没有变化或仅升高2.1°C。肾盂内外温度没有差异。
以连续模式使用功率设置高达40瓦且流速与临床实践中使用的流速相似的Tm:YAG似乎会导致冲洗液温度升高，这在UT内镜手术期间对肾组织不构成风险。
