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Comparative Study
. 2021 Sep;39(9):3503-3508.
doi: 10.1007/s00345-021-03634-4. Epub 2021 Mar 16.

Tissue effects of a newly developed diode pumped pulsed Thulium:YAG laser compared to continuous wave Thulium:YAG and pulsed Holmium:YAG laser

Stephan Huusmann  1 , Marcel Lafos  2 , Ingo Meyenburg  3 , Rolf Muschter  4 , Heinrich-Otto Teichmann  3 , Thomas Herrmann  5
Affiliations
Comparative Study

Tissue effects of a newly developed diode pumped pulsed Thulium:YAG laser compared to continuous wave Thulium:YAG and pulsed Holmium:YAG laser

Stephan Huusmann et al. World J Urol. 2021 Sep.

Abstract

Purpose: The objective of this study is to evaluate the laser-tissue effects of laser radiation emitted by a newly developed high frequency pulsed Tm:YAG laser in comparison to the continuous wave Tm:YAG laser and the pulsed Ho:YAG laser.

Methods: Ex-vivo experiments were performed on freshly slaughtered porcine kidneys in a physiological saline solution. Experiments were performed using two different laser devices in different settings: A Tm:YAG laser was operated in a pulsed mode up to 300 Hz and in a continuous wave (CW) mode. Results were compared with a 100 W standard pulsed Ho:YAG laser system. Comparative tissue experiments were performed at 5 W, 40 W and 80 W. The incision depth and the laser damage zone were measured under a microscope using a calibrated ocular scale.

Results: Increased laser power resulted in increased incision depth and increased laser damage zone for all investigated lasers in this set-up. The Ho:YAG created the largest combined tissue effect at the 5 W power setting and seems to be the least controllable laser at low power for soft tissue incisions. The CW Tm:YAG did not incise at all at 5 W, but created the largest laser damage zone. For the new pulsed Tm:YAG laser the tissue effect grew evenly with increasing power.

Conclusion: Among the investigated laser systems in this setting the pulsed Tm:YAG laser shows the most controllable behavior, insofar as both the incision depth and the laser damage zone increase evenly with increasing laser power.

Keywords: Continuous wave Thulium:YAG laser (CW); Holmium:YAG laser; Pulsed Thulium:YAG laser; Tissue interaction.

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Conflict of interest statement

S Huusmann: consultant for Boston Scientific and LISA Laser. HO Teichmann: consultant for LISA Laser. R Muschter: consultant for LISA Laser. TRW Herrmann: consultant for Karl Storz.

Figures

Fig. 1
Fig. 1
a Nomenclature of laser affected tissue layers after laser irradiation. b Histologic section of a laser cut in the porcine kidney with pulsed Tm:YAG at 80 W with marked damage zones
Fig. 2
Fig. 2
Incision depth of CW Tm:YAG, pulsed Tm:YAG and pulsed Ho:YAG at different laser energy levels
Fig. 3
Fig. 3
Laser damage zones for the different laser devices (a). Graphically added incision depth for Tm:YAG CW (b), pulsed Tm:YAG (c), pulsed Ho:YAG (d)
See this image and copyright information in PMC

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