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DGM001519.01 UM Sirius CE/ROTW
The following table shows the suggested maximum power and recommended fibers for endoscopic ablation,
vaporization, excision, incision, and coagulation of soft tissue in urological applications:
Table 1 Urology-Recommended treatment clinical parameters
NOTE: Laser settings are guidelines only; always start with low settings and increase them progressively to
achieve the desired tissue effect.
Benign Prostatic Hyperplasia
Note: Effect on tissue can be further tuned by the MasterPULSE when in pulsed mode: short pulse width generallty
enhances mechanical dissection, whereas long pulse width generally results in gentler cutting of tissue.
Other Soft Tissues
Note: Effect on tissue can be further tuned by the MasterPULSE when in pulsed mode: short pulse width generally
results in a more aggressive action, whereas long pulse width generally results in gentler ablation/cutting of
tissue.
Clinical Parameters for Urinary Lithotripsy
Pre-clinical and clinical testing have demonstrated that urinary calculi can be safely and effectively fragmented
from pulsed emission starting with power settings of 0.5 or 0.6 Joules and at a frequency of 5 or 6 Hertz.
The use of high-power output settings requires special attention, especially when the fiber tip is in close
proximity to the ureteral walls in order to avoid ureter perforation. Similarly, for lithotripsy in other body areas,
the use of high-power output settings requires special attention, especially when the fiber tip is in close
proximity to tissues and structures that are particularly thin and fragile and/or must not be perforated/ablated
as nerves, vessels and arteries functional membranes.
For effective fragmentation, the tip of the optical fiber should be directly in contact with the stone. Whenever
possible, laser energy should be directed at the side of, or at weak points, in the stone.
The stone should be progressively reduced in size by slowly removing small fragments.
Continuous irrigation should be used to wash away stone fragments and to provide cooling of the treatment
site.
DO NOT START LASERING AT MAXIMUM POWER. Begin the procedure with a low power (e.g. 5-10W in pulsed
mode) and increase the output power until the desired effect is achieved.
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