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01-01-2019 | Original Article

Is loss of power output due to laser fiber degradation still an issue during prostate vaporization using the 180 W GreenLight XPS laser?

Authors: Thomas Hermanns, Nico C. Grossmann, Marian S. Wettstein, Etienne X. Keller, Christian D. Fankhauser, Oliver Gross, Benedikt Kranzbühler, Martin Lüscher, Alexander H. Meier, Tullio Sulser, Cédric Poyet

Published in: World Journal of Urology | Issue 1/2019

Abstract

Purpose

To investigate whether heat-induced fiber degradation and loss of power output, which occurred during GreenLight laser vaporization (LV) of the prostate using the first- and second-generation 80 and 120 W laser, are still an issue during LV using the upgraded third generation 180 W GreenLight XPS™ laser.

Methods

Laser beam power output of 53 laser fibers was measured at baseline and after every 25 kJ of delivered energy during routine 180 W GreenLight XPS™ LV in 47 patients with prostatic bladder outflow obstruction. After the procedures, the fiber tips were microscopically examined.

Results

The median applied energy per patient was 178 kJ [interquartile range (IQR): 106–247]. Loss of power output during the procedure was detectable in all fibers. After the application of 25, 150, and 250 kJ, the median power output decreased to 77% (IQR 59–87), 57% (IQR 32–71), and 51% (IQR 37–64) of the baseline value. Nine fibers (17%) remained on a relatively high power output level (> 80% of the initial output), while 13 fibers (25%) showed an end-of-procedure power output of less than 20%. Microscopy of the fiber tip revealed mild-to-moderate overall degradation and increasing degradation with higher energy delivered.

Conclusion

Despite changes in fiber design, heat-induced fiber damage and loss of power output remain an issue during 180 W GreenLight XPS™ LV. Whether modifications of the surgical technique can prevent impairment of fiber performance needs to be further evaluated.

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Title: Is loss of power output due to laser fiber degradation still an issue during prostate vaporization using the 180 W GreenLight XPS laser?
Authors: Thomas Hermanns
Nico C. Grossmann
Marian S. Wettstein
Etienne X. Keller
Christian D. Fankhauser
Oliver Gross
Benedikt Kranzbühler
Martin Lüscher
Alexander H. Meier
Tullio Sulser
Cédric Poyet
Publication date: 01-01-2019
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 1/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-018-2377-5

At a glance: The STEP trials

Springer Medicine

Is loss of power output due to laser fiber degradation still an issue during prostate vaporization using the 180 W GreenLight XPS laser?

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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