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Pulse modulation with Moses technology improves popcorn laser lithotripsy.

Kristian M Black1, Ali H Aldoukhi2, Joel M H Teichman3

  • 1Medical Sciences Unit I, Division of Endourology, Department of Urology, University of Michigan, 1301 Catherine St, Room 4432, Ann Arbor, MI, 48109, USA. krismbla@med.umich.edu.

World Journal of Urology
|June 8, 2020
PubMed
Summary
This summary is machine-generated.

Moses™ distance mode enhances holmium laser lithotripsy by increasing stone fragmentation and reducing larger particle creation during non-contact popcorn lithotripsy. This technique offers improved stone-dusting capabilities for better clinical outcomes.

Keywords:
DustingFragmentationHolmiumLaserMoses technologyUreteroscopy

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Area of Science:

  • Urology
  • Laser Lithotripsy
  • Nephrolithiasis Treatment

Background:

  • Holmium:YAG (Ho:YAG) laser lithotripsy is a standard treatment for kidney stones.
  • Moses™ technology aims to improve Ho:YAG laser stone fragmentation.
  • Popcorn lithotripsy is a non-contact laser lithotripsy technique.

Purpose of the Study:

  • To compare the effectiveness of short pulse (SP) and Moses™ distance (MD) modes for Ho:YAG laser lithotripsy.
  • To evaluate fragment size distribution and mass loss in an in vitro model using popcorn lithotripsy settings.

Main Methods:

  • BegoStones were fragmented using a 120 W Ho:YAG laser with a 230 μm fiber.
  • SP and MD modes were tested at 20 W and 40 W settings.
  • Fragment size distribution, mass lost in fluid, and high-speed video analysis of fragmentation dynamics were assessed.

Main Results:

  • At 20 W, MD mode resulted in greater mass loss and fewer fragments ≥ 2 mm compared to SP mode (p<0.05).
  • At 40 W, no fragments ≥ 2 mm were produced, with no significant difference between MD and SP modes.
  • MD mode at 20 W showed a higher percentage of indirect strikes and distinct vapor bubble dynamics compared to SP mode.

Conclusions:

  • Moses™ distance mode enhances non-contact laser lithotripsy (popcorn lithotripsy) at lower power settings.
  • Pulse modulation in MD mode promotes more effective stone fragmentation.
  • This technique may lead to improved stone-dusting and reduced need for secondary procedures.