Kantapon Tangwiwat: My name is Kantapon Tangwiwat, I'm a research fellow at Curiosity and Innovation Laboratory at UCI. I'm presenting one of our projects, Characterization of Intrarenal Temperature and Pressure During Ex Vivo High-Energy Thulium Laser Lithotripsy. We focus on the safety profile of high energy thulium laser fiber lithotripsy. Using advance fragmentation power or AFP, compare with regular power or RP, AFP has been introduced to improve fragmentation efficiency. However, its safety profile regarding intrarenal temperature and pressure remains poorly characterized.

We utilize two ex vivo porcine kidneys. Each was implanted with three human calcium oxalate monohydrate stones via pyelostomy. Transparenchymal temperature and pressure probes were placed into stone-bearing calyx and renal pelvis. Both kidneys were maintained in the 37 degree water bath. Laser lithotripsy was performed. One kidney was treated with AFP at 30 Joules at 1 Hertz while the other kidney was treated with RP at 4 Joules at 8 Hertz.

Irrigation was performed using room temperature saline at 150 millimeter mercury. Results, AFP demonstrate a substantially shorter laser filing time than RP 7.5 versus 17 minutes. AFP also show lower mean and peak, entire renal temperature and pressure with a maximum temperature of 31 degrees Celsius and a peak pressure of 56 millimeter mercury. Regarding fragmentation characteristics, AFP produce predominantly larger fragments whereas RP produce a higher proportion of five fragments. In conclusion, AFP improves efficiency while maintaining a favorable safety profile. Thank you.