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Initial Clinical Experience with a Modulated Holmium Laser Pulse—Moses Technology: Does It Enhance Laser Lithotripsy Efficacy?

Authors :
Michael Mullerad
Jonatan R. A. Aguinaga
Tareq Aro
Alexander Kastin
Oleg Goldin
Alexander Kravtsov
Akram Assadi
Shadie Badaan
Gilad E. Amiel
Source :
Rambam Maimonides Medical Journal, Vol 8, Iss 4, p e0038 (2017)
Publication Year :
2017
Publisher :
Rambam Health Care Campus, 2017.

Abstract

Objective The Lumenis® High-power Holmium Laser (120H) has a unique modulated pulse mode, Moses™ technology. Moses technology modulates the laser pulse to separate the water (vapor bubble), then deliver the remaining energy through the bubble. Proprietary laser fibers were designed for the Moses technology. Our aim was to compare stone lithotripsy with and without the Moses technology. Methods We designed a questionnaire for the urologist to fill immediately after each ureteroscopy in which the Lumenis 120H was used. We compared procedures with (n=23) and without (n=11) the use of Moses technology. Surgeons ranked the Moses technology in 23 procedures, in comparison to regular lithotripsy (worse, equivalent, better, much better). Laser working time and energy use were collected from the Lumenis 120H log. Results During 4 months, five urologists used the Lumenis 120H in 34 ureteroscopy procedures (19 kidney stones, 15 ureteral stones; 22 procedures with a flexible ureteroscope, and 12 with a semi-rigid ureteroscope). Three urologists ranked Moses technology as much better or better in 17 procedures. In 2 cases, it was ranked equivalent, and in 4 cases ranking was not done. Overall, laser lithotripsy with Moses technology utilized laser energy in less time to achieve a satisfying stone fragmentation rate of 95.8 mm3/min versus 58.1 mm3/min, P=0.19. However, this did not reach statistical significance. Conclusion The new Moses laser technology demonstrated good stone fragmentation capabilities when used in everyday clinical practice.

Details

Language :
English
ISSN :
20769172
Volume :
8
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Rambam Maimonides Medical Journal
Publication Type :
Academic Journal
Accession number :
edsdoj.00099b25e09149df94018f675377aad7
Document Type :
article
Full Text :
https://doi.org/10.5041/RMMJ.10315