Yamashita Shimpei, Inoue Takaaki, Imai Satoshi, Maruyama Yohei, Iwahashi Yuya, Deguchi Ryusuke, Kohjimoto Yasuo, Fujisawa Masato, Hara Isao
Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama City 641-0012, Japan.
Department of Urology, Hara Genitourinary Hospital, 5-7-17 Kitanagasadori, Chuo-ku, Kobe City 650-0012, Japan.
J Clin Med. 2023 Feb 10;12(4):1409. doi: 10.3390/jcm12041409.
The differences in dynamic thermal changes during laser lithotripsy between various laser pulse modes are unclear. We used thermography to evaluate the temporal changes in high-temperature areas during laser activation in order to compare different laser pulse modes. An unroofed artificial kidney model was used for the experiments. The laser fired for 60 s with a laser setting of 0.4 J/60 Hz in the following four different laser pulse modes without saline irrigation: short pulse mode (SPM), long pulse mode (LPM), virtual basket mode (VBM) and Moses mode (MM). Using the first 30 s of moving images, we compared the ratio of a high-temperature area of >43 °C to the total area every 5 seconds. The dynamic changes in fluid temperatures were shown to be different between the laser pulse modes. The extent of the high-temperature areas during the laser activation was large in the LPM and MM compared with the SPM and VBM. While the high-temperature areas expanded in an anterior direction in the early laser irradiation period using the LPM, they spread in a posterior direction in the early laser activation period using the MM. Although only the temperature profile in one specific plane was investigated, these results are considered useful for preventing thermal injuries during retrograde intrarenal surgeries.
各种激光脉冲模式下激光碎石术期间动态热变化的差异尚不清楚。我们使用热成像技术来评估激光激活期间高温区域的时间变化，以便比较不同的激光脉冲模式。实验使用了一个无顶的人工肾脏模型。在不进行盐水冲洗的情况下，以0.4 J/60 Hz的激光设置在以下四种不同的激光脉冲模式下发射激光60秒：短脉冲模式（SPM）、长脉冲模式（LPM）、虚拟篮状模式（VBM）和摩西模式（MM）。使用前30秒的动态图像，我们每5秒比较一次温度高于43°C的高温区域与总面积的比例。结果显示，不同激光脉冲模式下流体温度的动态变化有所不同。与SPM和VBM相比，LPM和MM在激光激活期间高温区域的范围更大。使用LPM时，高温区域在激光照射早期向前扩展，而使用MM时，高温区域在激光激活早期向后扩展。尽管仅研究了一个特定平面内的温度分布，但这些结果被认为有助于预防逆行性肾内手术期间的热损伤。
