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Temperature change during laser upper-tract endourological procedures: current evidence and future perspective
Theodoros Tokas1,2, Patrick Rice3, Christian Seitz4
1Department of Urology and Andrology, General Hospital Hall in Tirol, Hall in Tirol.
Current Opinion in Urology
|October 13, 2022
Summary
Laser lithotripsy generates heat, potentially harming tissue. Strategies like chilled irrigation and controlled laser use can lower temperatures, reducing complications during endourological treatments.
Area of Science:
- Urology
- Laser technology
- Biomedical engineering
Background:
- Laser lithotripsy utilizes holmium: yttrium-aluminum-garnet (Ho:YAG), thulium: yttrium-aluminum-garnet (Tm:YAG), and thulium fiber laser (TFL) technologies.
- Elevated temperatures during laser lithotripsy increase the risk of thermal damage and perioperative complications.
- Endourologists require better understanding of thermal effects and mitigation strategies.
Approach:
- Review of recent data on temperatures generated during laser lithotripsy.
- Analysis of factors influencing temperature rise.
- Evaluation of strategies to maintain lower temperatures.
Key Points:
- Temperatures during laser lithotripsy are comparable across Ho:YAG, Tm:YAG, and TFL lasers at equal power settings.
- Safe temperature profiles are observed below 40 W for all lasers.
- Techniques such as shorter laser on/off intervals, chilled irrigation, open irrigation, and ureteral access sheaths (UASs) help manage temperatures.
Conclusions:
- Managing thermal effects is crucial for safe and effective laser lithotripsy.
- Implementing specific strategies can significantly reduce the risk of thermal injury.
- Further education on temperature management is recommended for endourologists.
