Department of Urology, Research Center for Urinary Disease, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, 102218, China.
World J Urol. 2024 Oct 23;42(1):588. doi: 10.1007/s00345-024-05289-3.
The present study aimed to examine the relationship between irrigation velocity, operator duty cycle (ODC), and intrarenal temperature during retrograde intrarenal surgery with a superpulse fiber thulium laser.
Place the stones into the fresh isolated porcine kidneys, use puncture needle to place the temperature probe 2 mm around the stones, and place the pressure probes in the upper calyx, lower calyx, and renal pelvis. Place the entire setup in a 37 °C constant temperature water bath to simulate the human body environment. The laser power varies between 10 and 30 W, and the irrigation speed is 10-30 ml/min. Additionally, at a laser power of 20 W and an irrigation speed of 10 ml/min, different On-Duty Cycles (ODC) are set. Monitor the changes in temperature and pressure.
A direct proportionality of temperature in the kidney to the rate of irrigation has been reported between 10 W and 30 W laser powers. The percentage ratio of the rate of irrigation and power in the laser is 1:1, which can keep the temperature in the kidney at a safe level. At a laser power of 20 W and irrigation of 10 ml/min, the temperature inside the kidney increases sharply with the increase in ODC. By decreasing the ratio of ODC, the increase of temperature inside the kidney can be brought to a great reduction.
Maintaining a 1:1 ratio between laser power and irrigation speed can effectively prevent thermal damage or injury to kidney tissue.Additionally, by adjusting the On-Duty Cycle (ODC) ratio, the intrarenal temperature can also be reduced.
本研究旨在探讨逆行性肾内手术中，使用超脉冲光纤钬激光时，冲洗速度、操作人员占空比（ODC）与肾内温度之间的关系。
将结石放入新鲜分离的猪肾中，用穿刺针在结石周围 2mm 处放置温度探头，在肾盂、上盏和下盏放置压力探头。将整个装置放置在 37°C 的恒温水浴中，以模拟人体环境。激光功率在 10-30W 之间变化，冲洗速度为 10-30ml/min。此外，在激光功率为 20W 和冲洗速度为 10ml/min 的情况下，设置不同的占空比（ODC）。监测温度和压力的变化。
报告了在 10W 和 30W 激光功率之间，肾脏温度与冲洗速度之间存在直接的比例关系。激光功率和冲洗速度的比值为 1:1，可将肾脏内的温度保持在安全水平。在激光功率为 20W 和冲洗速度为 10ml/min 的情况下，随着 ODC 的增加，肾脏内部的温度急剧上升。通过降低 ODC 的比值，可以大大降低肾脏内部的温度升高。
保持激光功率和冲洗速度的 1:1 比值可以有效防止热损伤或肾组织损伤。此外，通过调整占空比（ODC），也可以降低肾内温度。
