ArticleScientific reports2026
Laser, irrigation, and suction settings to optimize intra-renal temperature and pressure during automated laser lithotripsy in an ex vivo study part I.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Intrarenal thermal and pressure dynamics during ureteroscopy: an in vitro study.BJU international · 2026Article
- Paradigm shifts in fluid management using suction irrigation pressure autoregulating systems in modern flexible ureteroscopy with flexible and navigable suction access sheath: an evidence-based narrative from EAU Endourology.Current opinion in urology · 2026Review
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Authors and funding
16 authors.
Funding
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Abstract
This study evaluated the effects of various laser, irrigation, and suction parameters on intra-renal temperature (IRT) and pressure (IRP) using an ex vivo porcine kidney. We introduced a novel Laser: Stop ratio (LS ratio), which automatically balances activation and resting periods. Only kidneys with a 10 mL pelvo-calyceal volume were used to assess the parameters [Thulium fiber laser (TFL) and Holmium: Yttrium-Aluminum-Garnet (Ho: YAG): 1.0 J/20Hz, 0.5 J/40Hz], pump-based irrigation of 30 mmHg (P30) and 50 mmHg (P50), LS ratios from 2:4 to 12:4, and continuous laser activation, with or without the flexible and navigable suction ureteral access sheath (FANS-UAS). With FANS-UAS, a Laser: Active suction: Rest ratio of 4:2:4 was applied at 200 mmHg suction. IRT and IRP were recorded every 30 s for 15 min, with dangerous thresholds set at > 50 °C for over 1 min or > 56 °C at any time. Under P30 and P50, the IRP remained below safety thresholds. Regarding IRT, for P30, TFL (1.0 J/20Hz) allowed unlimited pop-dusting at lower LS ratios (2:4), while TFL (0.5 J/40Hz) supported this even at higher LS ratios (4:4). Ho: YAG enabled longer pop-dusting durations, particularly at higher LS ratios (6:4) with adequate resting time. For P50, pop-dusting was unlimited at all settings with an LS ratio of 12:4 with adequate resting time. FANS-UAS allowed continuous pop-dusting. The LS ratio may offer insights into automatic laser fragmentation by balancing safety and efficiency. These findings suggest practical strategies for automated laser activation in robot-assisted flexible ureteroscopy.
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