Posts made in December 2018

Critical Success Factors for Successful Holmium Laser Lithotripsy

Understanding Performance & Control

The evolution of technology typically attempts to enhance ‘performance’.  However, it’s important to point out; bigger doesn’t always translate into better. In the world of holmium laser lithotripsy excellence in technical engineering can improve efficiency, facilitate surgical precision and enhance the fundamental parameters of performance.  Specifically, as it relates to ‘power’, less can actually translate into more!

Power versus Energy – There is a common misunderstanding that greater power (measured in watts) yields greater performance.  While adequate power is an important component to the performance of any laser, it is the energy delivered at the fiber-tissue interface that facilitates the “performance”, which in the case of laser lithotripsy, is fragmentation of the stone.  This output energy is measured in joules (watts/cm²) and the HYPHO urology lasers boast the highest output energy in their class. Simply put; Innovative engineering has led to more efficient use of input power, leading greater output energy. 

Surgical Precision & Control – Another critical component of performance is control, especially with calculi in the upper ureter and kidney.  A fundamental objective in these areas is to maintain the stability of the stone and minimize the risk of retropulsion and inadvertent stone migration. Multiple evidence-based clinical studies available in the public domain have documented the direct relationship between longer pulse length and increased stone stability.  In that regard, the HYPHO urology lasers for lithotripsy have the longest pulse length of ANY holmium laser on the market today, maximizing control and minimizing the risk of retroplusion and inadvertent stone migration.

A final thought; while some manufacturers promote high powered (watts) ‘2 in 1’ laser systems, which cost considerably more, it’s important to clarify that these systems can only be used for one procedure at one time.  In that regard, when considering investment in laser technology which is capable of multiple functionality, it is pertinent to investigate the  cost of two individual laser systems which of course could be used simultaneously and actually increase productivity and availability of service.

For more information on innovations in holmium laser engineering and the performance and control advantages of the HYPHO compact holmium urology laser for lithotripsy, contact the team at Surgical Lasers Inc. today.

Fragmentation and Dusting with the HYPHO Holmium Laser

The new compact (110V) HYPHO holmium laser is engineered and approved to perform multiple medical procedures including laser lithotripsy (fragmentation and “dusting”) and related soft tissue procedures (ablation & coagulation of soft tissue such as bladder tumours).  As it relates to its primary functionality, the new HYPHO urology laser is designed to maximize performance comprising simultaneous speed of ablation, safety & control.

The two common methods for the destruction and removal of kidney and bladder stones with a holmium laser are; fragmentation & “dusting”.  Fragmentation, is the traditional method associated with holmium laser lithotripsy which involves using the laser and fiber(s) to access and break down the stone into smaller pieces which are then removed with a basket.  Recently, a newer fragmentation technique referred to as “dusting” has been developed, which involves breaking the stones into small enough pieces for the patient to pass on their own, hence eliminating the requirement for basket retrieval. 

Stone “Dusting”; Reducing Total Treatment Time   “Dusting” the stone with a holmium laser and eliminating the requirement for basket retrieval can reduce total treatment time.  A more controlled form of fragmentation, “dusting” which breaks away smaller particles typically from the perimeter of the calculi, can be performed by increasing the photo-thermal interaction on the target tissue. In order to facilitate a true “dusting” interaction, the laser must either support; 1.)  high frequencies (measured in Hz), or 2.) longer pulse durations (measured in µsec). 

Generally speaking; higher powered (80+ watts), higher frequency (60 – 80 Hz), short pulse lasers which facilitate “dusting” run on 220V power and can be cost prohibitive. Lower cost, lower powered (25 – 30 watts) portable devices typically don’t support either high enough frequencies or long enough pulse durations to facilitate “dusting”.  The HYPHO urology lasers are truly capable of “dusting” which is facilitated by the longest pulse duration of any holmium laser on the market.

For more information on innovations in holmium laser engineering and the performance and control advantages of the HYPHO compact (110V) holmium urology laser for lithotripsy, contact the team at Surgical Lasers Inc. today.