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Ex vivo study of Ho:YAG and thulium fiber lasers for soft tissue surgery: which laser for which case?

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Abstract

The goal of this study was to assess the ablation, coagulation, and carbonization characteristics of the holmium:YAG (Ho:YAG) laser and thulium fiber lasers (TFL). The Ho:YAG laser (100 W av.power), the quasi-continuous (QCW) TFL (120 W av.power), and the SuperPulsed (SP) TFL (50 W av.power) were compared on a non-frozen porcine kidney. To control the cutting speed (2 or 5 mm/s), an XY translation stage was used. The Ho:YAG was tested using E = 1.5 J and Pav = 40 W or Pav = 70 W settings. The TFL was tested using E = 1.5 J and Pav = 30 W or Pav = 60 W settings. After ex vivo incision, histological analysis was performed in order to estimate thermal damage. At 40 W, the Ho:YAG displayed a shallower cutting at 2 and 5 mm/s (1.1 ± 0.2 mm and 0.5 ± 0.2 mm, respectively) with virtually zero coagulation. While at 70 W, the minimal coagulation depth measured 0.1 ± 0.1 mm. The incisions demonstrated zero carbonization. Both the QCW and SP TFL did show effective cutting at all speeds (2.1 ± 0.2 mm and 1.3 ± 0.2 mm, respectively, at 30 W) with prominent coagulation (0.6 ± 0.1 mm and 0.4 ± 0.1 mm, respectively, at 70 W) and carbonization. Our study introduced the TFL as a novel efficient alternative for soft tissue surgery to the Ho:YAG laser. The SP TFL offers a Ho:YAG-like incision, while QCW TFL allows for fast, deep, and precise cutting with increased carbonization.

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Authors and Affiliations

  1. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia

    Mark Taratkin, Ekaterina Laukhtina, Leonid Spivak, Vasily Mikhailov & Dmitry Enikeev

  2. NTO “IRE-Polus”, One Vvedenskogo Sq, Fryazino, Moscow Region, Russia, 141120

    Anastasia Kovalenko

  3. Centralized Pathology Department, Sechenov University, Moscow, Russia

    Nina Paramonova & Yuriy Strakhov

  4. Faculty of Medicine, Philipps University Marburg, Marburg, Germany

    Luca Johann Wachtendorf & Semil Eminovic

  5. Department of Urology, University of California, Irvine, CA, USA

    Andrew Sheya Afyouni & Zhamshid Okhunov

  6. Institute of Linguistics and Intercultural Communication, Sechenov University, Moscow, Russia

    Marina Karagezyan

  7. Department of Urology, Spital Thurgau AG, Pfaffenholzstrasse 4, 8501, Frauenfeld, Switzerland

    Thomas RW Herrmann

  8. Department of Urology, Hannover Medical School, Hannover, Germany

    Thomas RW Herrmann

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  1. Mark Taratkin
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  2. Anastasia Kovalenko
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Correspondence to Mark Taratkin.

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Taratkin, M., Kovalenko, A., Laukhtina, E. et al. Ex vivo study of Ho:YAG and thulium fiber lasers for soft tissue surgery: which laser for which case?. Lasers Med Sci 37, 149–154 (2022). https://doi.org/10.1007/s10103-020-03189-7

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