Elhilali Mostafa M, Badaan Shadie, Ibrahim Ahmed, Andonian Sero
1 Department of Urology, Royal Victoria Hospital, McGill University Health Centre , Montreal, Canada .
2 Department of Urology, Rambam Health Care Campus , Haifa, Israel .
J Endourol. 2017 Jun;31(6):598-604. doi: 10.1089/end.2017.0050. Epub 2017 Apr 25.
To evaluate in vitro and in vivo effects of Moses technology in Holmium laser and to compare it with the Regular mode in terms of lithotripsy efficiency and laser-tissue interactions.
The Lumenis Pulse™ P120H holmium laser system together with Moses D/F/L fibers were used to compare the Regular mode with the Moses modes in stone retropulsion by using a high-speed camera, and stone ablation efficiency. In addition, a porcine ureteroscopy model was used to assess stone fragmentation and dusting as well as laser-tissue interaction with the ureteral wall.
After a laser pulse, in vitro stone displacement experiments showed a significant reduction in retropulsion when using the Moses mode. The stone movement was reduced by 50 times at 0.8 J and 10 Hz (p < 0.01). The pronounced reduction of retropulsion in the Moses mode was clearly observed during fragmentation setting (high energy) and dusting (low energy, high Hz). In addition, stone fragmentation tests showed that the Moses modes resulted in a significantly higher ablation volume when compared with the Regular mode (160% higher; p < 0.001). In vivo assessment also supported the reduction in retropulsion when treating stones in the porcine kidney. Histological analysis of the porcine ureter after direct lasing in the Moses mode suggested less damage than in the Regular mode.
The Moses technology resulted in more efficient laser lithotripsy, in addition to significantly reduced stone retropulsion, and displayed a margin of safety that may result in a shorter procedural time and safer lithotripsy.
评估摩西技术在钬激光中的体外和体内效果，并在碎石效率和激光与组织相互作用方面将其与常规模式进行比较。
使用科医人脉冲™P120H钬激光系统以及摩西D/F/L光纤，通过高速摄像机比较常规模式和摩西模式在结石后推方面的差异以及结石消融效率。此外，使用猪输尿管镜模型评估结石破碎和粉末化情况以及激光与输尿管壁的组织相互作用。
激光脉冲后，体外结石位移实验表明，使用摩西模式时后推明显减少。在0.8 J和10 Hz时，结石移动减少了50倍（p < 0.01）。在破碎设置（高能量）和粉末化（低能量，高频率）过程中，明显观察到摩西模式下后推显著减少。此外，结石破碎测试表明，与常规模式相比，摩西模式导致的消融体积显著更高（高160%；p < 0.001）。体内评估也支持在治疗猪肾结石时后推减少。对猪输尿管进行摩西模式直接激光照射后的组织学分析表明，其损伤比常规模式小。
摩西技术除了显著减少结石后推外，还能实现更高效的激光碎石，并且显示出一定的安全性优势，这可能会缩短手术时间并使碎石更安全。
