Lasers in clinical urology: state of the art and new horizons
Lasers in clinical urology: state of the art and new horizons
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DOI：
10.1007/s00345-007-0163-x
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发表时间：
2007-06-01
影响因子：
3.4
通讯作者：
Teichman, Joel M. H.
中科院分区：
文献类型：
--
作者：
Marks, Andrew J.;Teichman, Joel M. H.
我们对当前和新兴的泌尿科激光器进行了概述。我们开始概述钬：YAG激光。Ho：YAG激光是内窥镜碎石术的金标准碎石方式，与良性前列腺增生症（BPH）的标准电灼经尿道前列腺切除术相比，具有优势。目前正在研究的现有激光技术包括倍频双脉冲Nd：Yag（FREDDY）和高功率磷酸钛氧钾（KTP）激光器。FREDDY激光为腔内碎石术提供了一种经济实惠且安全的选择，但它不能破碎所有结石成分，也不适用于软组织。高功率KTP激光在前列腺增生症的消融治疗中显示出良好的应用前景。铒：YAG激光的初步实验表明，与Ho：YAG相比，它提高了碎石效率，具有更精确的消融和切割性能，但缺乏足够的光纤限制了其在泌尿外科的应用。铥：YAG光纤激光器还表现出与Ho：YAG相当的组织消融和切割性能。最后，光纤激光器的紧凑尺寸，便携性和低维护时间表可能使它们能够塑造未来泌尿科医生使用激光器的方式。
We present an overview of current and emerging lasers for Urology. We begin with an overview of the Holmium:YAG laser. The Ho:YAG laser is the gold standard lithotripsy modality for endoscopic lithotripsy, and compares favorably to standard electrocautery transurethral resection of the prostate for benign prostatic hyperplasia (BPH). Available laser technologies currently being studied include the frequency doubled double-pulse Nd:Yag (FREDDY) and high-powered potassium-titanyl-phosphate (KTP) lasers. The FREDDY laser presents an affordable and safe option for intracorporeal lithotripsy, but it does not fragment all stone compositions, and does not have soft tissue applications. The high power KTP laser shows promise in the ablative treatment of BPH. Initial experiments with the Erbium:YAG laser show it has improved efficiency of lithotripsy and more precise ablative and incisional properties compared to Ho:YAG, but the lack of adequate optical fibers limits its use in Urology. Thulium:YAG fiber lasers have also demonstrated tissue ablative and incision properties comparable to Ho:YAG. Lastly, compact size, portability, and low maintenance schedules of fiber lasers may allow them to shape the way lasers are used by urologists in the future.