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Simulation of Laser Lithotripsy-Induced Heating in the Urinary Tract
- Source :
- Journal of Endourology. 33:113-119
- Publication Year :
- 2019
- Publisher :
- Mary Ann Liebert Inc, 2019.
-
Abstract
- Purpose: Holmium laser lithotripsy is a common modality used to fragment urinary stones during ureteroscopy. Laser energy deposited during activation produces heat and potentially causes thermal bioeffects. We aimed to characterize laser-induced heating through a computational simulation. Materials and Methods: A finite-element model was developed and used to estimate temperature in the urinary tract. Axisymmetric models of laser lithotripsy in a renal calyx, the renal pelvis, and proximal ureter were created. Heat generation by laser and heat transfer were simulated under different laser powers between 5 and 40 W. Irrigation fluid flow was introduced at rates between 0 and 40 mL/min. The model was validated by comparison with previous in vitro temperature data in a test tube, then used to calculate heating and thermal dose in the three tissue models. Results: Simulated temperature rises agreed well with most in vitro experimental measurements. In tissue models, temperature rises depended strongly on laser power and irrigation rate, and to a lesser extent on location. Injurious temperatures were reached for 5–40 W laser power without irrigation, >10 W with 5 mL/min irrigation, 40 W with 15 mL/min irrigation, and were not found at 40 mL/min irrigation. Tissue injury volumes up to 2.3 cm(3) were calculated from thermal dose. Conclusions: The results suggest a numerical model can accurately simulate the thermal profile of laser lithotripsy. Laser heating is strongly dependent on parameters and may cause a substantial temperature rise in the fluid in the urinary tract and surrounding tissue under clinically relevant conditions.
- Subjects :
- medicine.medical_specialty
Hot Temperature
Urology
medicine.medical_treatment
Urinary system
Urinary stone
030232 urology & nephrology
Holmium laser
Lasers, Solid-State
Lithotripsy
law.invention
Kidney Calculi
03 medical and health sciences
0302 clinical medicine
law
Ureteroscopy
medicine
Humans
Computer Simulation
Kidney Pelvis
Experimental Endourology
medicine.diagnostic_test
business.industry
Temperature
Lithotripsy, Laser
Laser
Laser lithotripsy
030220 oncology & carcinogenesis
Ureter
business
Subjects
Details
- ISSN :
- 1557900X and 08927790
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- Journal of Endourology
- Accession number :
- edsair.doi.dedup.....64794bf494117258341714f25226aa10