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World Journal of Urology

, Volume 37, Issue 1, pp 181–187 | Cite as

Is loss of power output due to laser fiber degradation still an issue during prostate vaporization using the 180 W GreenLight XPS laser?

  • Thomas HermannsEmail author
  • Nico C. Grossmann
  • Marian S. Wettstein
  • Etienne X. Keller
  • Christian D. Fankhauser
  • Oliver Gross
  • Benedikt Kranzbühler
  • Martin Lüscher
  • Alexander H. Meier
  • Tullio Sulser
  • Cédric Poyet
Original Article
  • 66 Downloads

Abstract

Purpose

To investigate whether heat-induced fiber degradation and loss of power output, which occurred during GreenLight laser vaporization (LV) of the prostate using the first- and second-generation 80 and 120 W laser, are still an issue during LV using the upgraded third generation 180 W GreenLight XPS™ laser.

Methods

Laser beam power output of 53 laser fibers was measured at baseline and after every 25 kJ of delivered energy during routine 180 W GreenLight XPS™ LV in 47 patients with prostatic bladder outflow obstruction. After the procedures, the fiber tips were microscopically examined.

Results

The median applied energy per patient was 178 kJ [interquartile range (IQR): 106–247]. Loss of power output during the procedure was detectable in all fibers. After the application of 25, 150, and 250 kJ, the median power output decreased to 77% (IQR 59–87), 57% (IQR 32–71), and 51% (IQR 37–64) of the baseline value. Nine fibers (17%) remained on a relatively high power output level (> 80% of the initial output), while 13 fibers (25%) showed an end-of-procedure power output of less than 20%. Microscopy of the fiber tip revealed mild-to-moderate overall degradation and increasing degradation with higher energy delivered.

Conclusion

Despite changes in fiber design, heat-induced fiber damage and loss of power output remain an issue during 180 W GreenLight XPS™ LV. Whether modifications of the surgical technique can prevent impairment of fiber performance needs to be further evaluated.

Keywords

Prostatic hyperplasia Transurethral resection of prostate Lasers Disposable equipment Equipment failure analysis Laser fiber laser prostatectomy 

Notes

Acknowledgements

We thank Ms. Alexandra Veloudios for her administrative assistance.

Authors’ contribution

TH: protocol/project development, data collection and management, data analysis, manuscript writing and editing. NCG: protocol/project development, data collection and management, data analysis, manuscript writing and editing. MSW: protocol/project development, data collection, manuscript writing and editing. EXK: data collection and management, manuscript writing and editing. CDF: data collection and management, manuscript writing and editing. OG: data collection and management, manuscript writing and editing. BK: data collection and management, manuscript writing and editing. ML: data collection and management, manuscript writing and editing. AHM: technical support, data collection and management, manuscript writing and editing. TS: data collection and management, manuscript writing and editing. CP: protocol/project development, data collection and management, data analysis, manuscript writing and editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the local ethics committee (KEK-ZH-Number: 2012-518).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

345_2018_2377_MOESM1_ESM.tif (1.6 mb)
Supplemental Figure The median estimated power output of the surgeons at the end of the procedure correlates well with the measured end-of-procedure performance. Data are presented as median and interquartile range (TIFF 1649 kb)
345_2018_2377_MOESM2_ESM.docx (14 kb)
Supplementary material 2 (DOCX 14 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Thomas Hermanns
    • 1
    Email author
  • Nico C. Grossmann
    • 1
  • Marian S. Wettstein
    • 1
  • Etienne X. Keller
    • 1
  • Christian D. Fankhauser
    • 1
  • Oliver Gross
    • 1
  • Benedikt Kranzbühler
    • 1
  • Martin Lüscher
    • 1
  • Alexander H. Meier
    • 2
  • Tullio Sulser
    • 1
  • Cédric Poyet
    • 1
  1. 1.Department of UrologyUniversity Hospital Zürich, University of ZürichZurichSwitzerland
  2. 2.Institute of Fluid DynamicsETH ZürichZurichSwitzerland

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