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  • 1
    Language: English
    In: Journal of Endourology, July, 2010, Vol.24(7), p.1135(6)
    Description: Background and Purpose: Holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripsy is the standard lithotrite in ureteroscopy. We investigated the influence of pulse frequency, energy and length on the fragmentation efficiency of Ho:YAG laser lithotripsy in non-floating artificial stones in vitro. Materials and Methods: Stone fragmentation efficiency of three different Ho:YAG laser devices were evaluated in vitro at different pulse energy (1.0 and 2.0 J) and frequency settings (5 and 10 Hz), resulting in a standardized output power of 10W, respectively. Where possible, pulse length was modified (350 vs 700 [micro]sec). Each setting was performed with a 273 [micro]m and a 365 [micro]m fiber. Lithotripsy was conducted using non-repulsive stones consisting of soft stone (plaster of Paris) and hard stone composition (Fujirock type 4). Results: Our results showed an increased stone disintegration efficiency at higher pulse energy (2.0J/5Hz vs 1.0 J/10 Hz) independently of two fiber diameters and stone types applied in this study (P 〈 0.05 in 18 of 20 groups). Similarly, reduction of the pulse length from 700 to 350 [micro]sec resulted in a higher stone disintegration (P 〈 0.05 in 13 of 16 groups). This effect was most prominent when applied to soft stones. Higher fiber diameter was not constantly associated with an increase in stone disintegration. Conclusion: We demonstrate that an increase of pulse energy and a reduction of pulse length at a standardized output power of 10W can improve Ho:YAG laser fragmentation efficiency in vitro in nonfloating stones. These results may potentially affect clinical practice of Ho:YAG laser lithotripsy in impacted or large stones, when retropulsion is excluded.
    Keywords: Lithotripsy -- Health Aspects ; Ureteroscopy -- Usage ; Urinary Stones -- Diagnosis ; Urinary Stones -- Care And Treatment ; Urinary Stones -- Research
    ISSN: 0892-7790
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  • 2
    Language: English
    In: The Journal of Urology, April 2011, Vol.185(4), pp.e333-e333
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
    Source: ScienceDirect Journals (Elsevier)
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  • 3
    Language: English
    In: European Urology, November 2013, Vol.64(5), pp.762-764
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.eururo.2013.05.018 Byline: Felix Wezel, Jennifer Southgate Author Affiliation: (a) Jack Birch Unit of Molecular Carcinogenesis, Department of Biology, University of York, York, UK (b) Department of Urology, University Medical Centre Mannheim, Mannheim, Germany
    Keywords: Medicine
    ISSN: 0302-2838
    E-ISSN: 1873-7560
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  • 4
    Language: German
    In: Der Onkologe, 2017, Vol.23(10), pp.858-860
    Description: To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00761-017-0279-6 Byline: Felix Wezel (1), Christian Bolenz (1) Author Affiliation: (1) Klinik fur Urologie und Kinderurologie, Universitatsklinik Ulm, Prittwitzstr. 43, 89075, Ulm, Deutschland Article History: Registration Date: 18/07/2017 Online Date: 08/08/2017
    Keywords: Cancer Metastasis ; Cisplatin;
    ISSN: 0947-8965
    E-ISSN: 1433-0415
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  • 5
    Language: English
    In: BJU International, August, 2010, Vol.106(3), p.368(5)
    Description: To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1464-410X.2009.09059.x Byline: Thorsten Bach ([dagger]), Nina Huck (*), Felix Wezel (*), Axel Hacker (*), Andreas J. Gross ([dagger]), Maurice Stephan Michel (*) Keywords: benign prostatic enlargement; tissue ablation; coagulation; thulium : YAG; laser Abstract: Study Type - Aetiology (case series)Level of Evidence 4 OBJECTIVE To evaluate the ablative and haemostatic properties of the recently introduced 120-W thulium:yttrium-aluminium-garnet (Tm-YAG) laser and to assess these results against those of the previously introduced 70-W Tm-YAG laser. MATERIALS AND METHODS The ex-vivo model of the isolated blood-perfused porcine kidney was used to determine the ablation capacity, haemostatic properties and coagulation depth of a 2 [micro]m continuous-wave Tm-YAG laser. The energy was delivered using a 550-[micro]m and an 800-[micro]m bare-ended fibre. The results of the recently introduced 120-W Tm-YAG were compared to the established 70-W device. Kidney tissue was embedded for histological evaluation. After staining (haematoxylin and eosin, H&E; and NADH) of the specimen, the coagulation zone and depth of the necrotic tissue layer were measured. RESULTS With increased power output, the mean (sd) rate of vaporization of tissue increased, from 9.80 (3.03) g/10 min at 70 W to 16.41 (5.2) g/10 min at 120 W using the 550 [micro]m fibre. The total amount of ablated tissue using the 800 [micro]m fibre was lower than with the 550 [micro]m fibre. With increasing power output the bleeding rate remained stable in either group. Tissue penetration remained shallow, even with increasing power output. In contrast to H&E staining, where the coagulation zone was measured, NADH staining showed an inner zone of necrotic tissue, again with no difference between the 70- and the 120-W Tm-YAG. CONCLUSION The 120-W Tm-YAG offers significantly higher ablation rates than the 70-W device, and despite the increased rate of ablation with the 120-W Tm-YAG, the bleeding rate and depth of tissue penetration were comparable to those using the 70-W device. Author Affiliation: (*)Department of Urology, University Medical Centre Mannheim, Mannheim, and ([dagger])Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany Article History: Accepted for publication 10 September 2009 Article note: Thorsten Bach, Department of Urology, University Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68135 Mannheim, Germany., e-mail: thorsten.bach@umm.de
    Keywords: Rare Earth Metals -- Analysis ; Ablation (Surgery) -- Analysis ; Medical Lasers -- Analysis ; Rare Earth Metal Compounds -- Analysis
    ISSN: 1464-4096
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  • 6
    Language: English
    In: Revista Médica Clínica Las Condes, 01 March 2018, Vol.29(2), pp.155-162
    Description: Genitourinary (GU) cancers are amongst the most common cancer types, especially neoplasms of the prostate, bladder and kidney. While cure can often only be achieved surgically at early stages, management of advanced or metastatic disease requires systemic medical treatment. With the exception of testicular cancers, systemic therapy of GU cancers has a palliative character and aims to prolong survival and to increase quality of life. With the emergence of molecular targeted therapies such as receptor tyrosine kinase or checkpoint inhibitors, medical management of GU cancers has seen a dramatic progress within the last decade. Moreover, novel combinatorial and sequential therapies have been established thus providing more options for each individual patient but also rendering medical management of urologic tumors more complex. Finally, much progress has been achieved in deciphering the molecular landscapes of GU cancers by next generation sequencing, and novel biomarkers are under investigation to improve patient selection and to optimize systemic therapy. Key words: Prostate cancer, kidney cancer, bladder cancer, chemotherapy, immunotherapy
    Keywords: Prostate Cancer ; Kidney Cancer ; Bladder Cancer ; Chemotherapy ; Immunotherapy;
    ISSN: 0716-8640
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  • 7
    Language: English
    In: The Journal of Urology, 2010, Vol.183(4), pp.e495-e495
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
    Source: ScienceDirect Journals (Elsevier)
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  • 8
    Language: English
    In: The Journal of Urology, 2010, Vol.183(4), pp.e701-e702
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
    Source: ScienceDirect Journals (Elsevier)
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  • 9
    Language: English
    In: World Journal of Urology, 2010, Vol.28(2), pp.181-186
    Description: Byline: Felix Wezel (1), Gunnar Wendt-Nordahl (2), Nina Huck (1), Thorsten Bach (1), Christel Weiss (3), Maurice Stephan Michel (1), Axel Hacker (1) Keywords: Benign prostatic enlargement; Diode laser; KTP laser; TURP; Minimal invasive Abstract: Purpose Several diode laser systems were introduced in recent years for the minimal-invasive surgical therapy of benign prostate enlargement. We investigated the ablation capacities, hemostatic properties and extend of tissue necrosis of different diode lasers at wavelengths of 980, 1,318 and 1,470 nm and compared the results to the 120 W GreenLight[TM] HPS laser. Methods The laser devices were evaluated in an ex vivo model using isolated porcine kidneys. The weight difference of the porcine kidneys after 10 min of laser vaporization defined the amount of ablated tissue. Blood loss was measured in blood-perfused kidneys following laser vaporization. Histological examination was performed to assess the tissue effects. Results The side-firing 980 and 1,470 nm diode lasers displayed similar ablative capacities compared to the GreenLight[TM] HPS laser (n.s.). The 1,318-nm laser, equipped with a bare-ended fiber, reached a higher ablation rate compared to the other laser devices (each P 〈 0.05). A calculated 'output power efficiency per watt' revealed that the 1,318-nm laser with a bare-ended fiber reached the highest rate compared to the side-firing devices (each P 〈 0.0001). All three diode lasers showed superior hemostatic properties compared to the GreenLight[TM] HPS laser (each P 〈 0.01). The extend of morphological tissue necrosis was 4.62 mm (1,318 nm), 1.30 mm (1,470 nm), 4.18 mm (980 nm) and 0.84 mm (GreenLight[TM] HPS laser), respectively. Conclusion The diode lasers offered similar ablative capacities and improved hemostatic properties compared to the 120 W GreenLight[TM] HPS laser in this experimental ex vivo setting. The higher tissue penetration of the diode lasers compared to the GreenLight[TM] HPS laser may explain improved hemostasis. Author Affiliation: (1) Department of Urology, Mannheim Medical Center, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany (2) Department of Urology, Hospital Sindelfingen-Boblingen, Arthur-Gruber-Str. 70, 71065, Sindelfingen, Germany (3) Department of Medical Statistics, Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany Article History: Registration Date: 11/12/2009 Received Date: 02/08/2009 Accepted Date: 10/12/2009 Online Date: 25/12/2009 Article note: F. Wezel and G. Wendt-Nordahl have contributed equally to this work.
    Keywords: Benign prostatic enlargement ; Diode laser ; KTP laser ; TURP ; Minimal invasive
    ISSN: 0724-4983
    E-ISSN: 1433-8726
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  • 10
    Language: English
    In: The Journal of Urology, 2010, Vol.183(4), pp.e745-e745
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
    Source: ScienceDirect Journals (Elsevier)
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