Category: Stones: Ureteroscopy

VS1-2 - SuperPulse Thulium Fiber Laser for Ureteroscopic Lithotripsy: 1 Year Experience

Fri, Sep 21
10:00 AM - 12:00 PM

Introduction & Objective :

Laser lithotripsy (LL) has become a first-line modality for treatment of many diagnoses of urinary tract stones. The de facto gold standard laser source for LL systems is a Ho:YAG (Ho) laser emitting at the wavelength of 2.10 µm. Recently, a SuperPulse Tm fiber laser emitting at 1.94 µm has been proposed as a viable alternative to Ho laser. In this work, we present a feasibility clinical application of new SuperPulse Tm Fiber Laser system for lithotripsy.


Methods : SuperPulse Tm fiber laser has been cleared for clinical use by the Ministry of Health of Russian Federation. The study protocol has been approved by the institutional Ethical Review Board. SuperPulse Tm fiber laser system capable of operation with up to 50 W average power, 500 W peak power, and 2000 Hz rep rate was used in this study. The study is on-going. Up to April 2018, total of 136 subjects (age range 19-82) have been enrolled into the study and total of 145 stones have been surgically treated with the device.  Routine preoperative exam included multispiral CT (MCT) scan with the evaluation of stone density and location. Total procedure time, laser on time, stone extraction (when applicable) time were assessed. Control exam with kidney MCT was provided 30 days after operation.


Results :

Stone free-rates (no residual fragments) were 94% for kidney stones, 96% for ureter stones and 100% for bladder stones 30 days after operation. On the dataset obtained and analyzed so far, the operation time and the laser on time varied between 4 to 19 min and 12 s to 8 min, respectively. No accidental damage of soft tissues was observed. The post-operative hospital stay time was 2.4 days on average.


Conclusions : Data available so far indicate that SuperPulse Thulium fiber laser is efficacious and safe for lithotripsy

Alexey G. Martov

Head of Urology department
Federal Medical-Biological Agency of Russian Federation State Institute of Continuous Medical Education, Division of Urology, Moscow, Russia
Moscow, Moskva, Russia

Martov Alexey G., MD, PhD, Honored Doctor of Russia
Professor and Chairman, Department of Urology, Federal Medico-biology Agency
Professor of Urology, Russian Medical Academy of Postgraduate Education
Head of Urology Department, Moscow City Hospital № 57
Ph/fax: +7 499 7800853
e-mail: martovalex@mail.ru
www.amartov.ru

1978-1982. First Moscow Medical Institute
1982-1988. Residenship, Institute of Urology, Moscow
1988. Doctorate Thesis «Percutaneous Treatment of Kidney Stones»
1988-2006. Institute of Urology, from Head of Endourology Department to Vice-President
1993. PhD degree, «Endourological Treatment of Upper Urinary Tract Diseases»
2006 – p. t. Head of Urology Department, Moscow City Hospital №57, Professor of Urology, Russian Medical Academy of Postgraduate Education
2012 – p.t. Professor and Chairman Department of Urology, Federal Medico-biology Agency, Russia


Activities
• Founding Member and President of the Russian Endourology and New Urotechnology Society
• Vice-president of the Russian Urology Association
• Co-Editor of Russian Journal “Urology”
• Member of EAU, SIU, AUA, Endourological Society
• CROES, ESUT activity
• Director of Training Center for Endourology, Moscow, Russia
• Honorary member of Russian, Georgian and Azerbaijan Urology Association
Specialisations / Interests
• Endourology
• BPH
• Stone desease
• Urooncology

over 400 scientific publications (PubMed-cited Journals), 15 books, 35 books chapters
3 educational CD for Urologists (Endourology, BPH, Prostate cancer)
Numerous international invitations for live surgery meetings / presentations / workshops / congresses and teaching events in Russia and countries of former Soviet Union, Germany, France, Austria, Switzerland, Turkey, Sweden etc.
Moscow, 2018

Dmitry V. Ergakov

Associate Professor
Federal Medical-Biological Agency of Russian Federation State Institute of Continuous Medical Education, Division of Urology, Pletnews Municipal Hospital, Moscow, Russia
Moscow, Moskva, Russia

Mirab Guseynov

Federal Medical-Biological Agency of Russian Federation State Institute of Continuous Medical Education, Division of Urology, Moscow, Russia
Moscow, Moskva, Russia

Vincent De Coninck

Urologist
AZ Klina
Brasschaat, Antwerpen, Belgium

Vincent De Coninck graduated as a medical doctor from the Free University of Brussels, Belgium (VUB) in 2011. He became a certified urologist in 2017 after a training at the University Hospital of Brussels (Prof. Dr. Dirk Michielsen) and OLV Aalst (Prof. Dr. Alex Mottrie), where he developed a special interest in the minimal invasive treatment of benign and malignant pathologies. In the same year, he became Fellow of the European Board of Urology.
In 2018, he completed a one-year fellowship program of the Endourological Society in Paris, France under the supervision of Prof. Dr. Olivier Traxer. During that fellowship, he also obtained a diploma in urolithiasis, organized by Dr. Michel Daudon at the Sorbonne University in Paris, France. Afterwards, he was trained in HoLEP by Dr. Karin Lehrich in Berlin, Germany.
Currently, he is completing a three-month fellowship under the supervision of Dr. Guido Giusti in Milan, Italy. In December 2018, he will start working as an endourologist in AZ Klina, Brasschaat, Belgium. He will focus on the medical and surgical treatment of kidney stones and benign prostatic obstruction (HoLEP) and he will continue publishing articles relating to the management of patients with renal stone disease.

Etienne X. Keller

Fellow of the ES
Sorbonne Université, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, AP-HP, Hôpital Tenon, F-75020 Paris, France
Paris, Ile-de-France, France

Olivier O. Traxer

Professor
Sorbonne Universite, GRC n020 Lithiase Renale, AP-HP, Hospital Tenon, F-75020 Paris, France
Paris, Ile-de-France, France

Sergey V. Dutov

Assistant
State Clinical Hospital under the name of D.D. Pletnev
Moscow, Not Applicable, Russia