研究目的
To estimate the minimum amount of energy required to ablate 1?mm3 of stone, according to different stone compositions and energy parameters, with the ultimate purpose that these estimates will be useful to improve pre-operative planning strategies and predictive tools.
研究成果
This in?vitro study shows for the first time a volumetric evaluation of Ho:YAG efficiency by the ablation volume per pulse on human stone samples. Calcium oxalate monohydrate needs tenfold and fivefold higher laser energy to treat the same volume than uric acid and cystine, respectively. High pulse energy will need less total delivered energy to dust but will produce bigger fragments, traducing the compromise which has to be done in clinical practice. The required energy to treat may represent a valuable information in surgical planning and post-operative accuracy evaluation.
研究不足
The study evaluated ablation volume using ideal experimental conditions, which are substantially different from the current clinical practice; each pulse was delivered cutting the laser fiber beforehand, whereas during intracorporeal lithotripsy the laser fiber gradually deteriorates without the possibility of cutting it after each pulse. Moreover, contact mode for the delivery of laser energy was used, which might have overestimated the ablation volume as compared to clinical practice. A low-power, short-pulse laser generator was used, which may represent a limitation.
