Holmium: Yttrium Aluminum Garnet Laser and Guidewires: Is There a Durability Difference Among Guidewires Against Laser Energy? An In Vitro Experimental Study

Abstract

Purpose: To evaluate the durability differences between five different type of guidewires against laser energy in an in vitro experimental ureteral model. Methods: The study was performed at the Department of Urology, Medicine Faculty of Ahi Evran University. An in vitro experimental ureteral model was created for the work; a silicon ureteral model in a saline-filled container. Experiments were performed on five different type of guidewires; ZIPwire, Sensor polytetrafluoroethylene (PTFE) Nitinol guidewire, Roadrunner (R) PC wire guide, Amplatz Super Stiff, and Zebra Urologic Guidewire. These guidewires were grouped from one to five, respectively. Laser fibers were contacted to the guidewire, and laser energy was fired to the premarked tip and body parts in different adjustments. Results: The breakage of the guidewires was detected only on the flexible tip parts in group 1a, group 1b, group 2a, group 2b, group 4a, and group 4b. The body parts of the guidewires were resistant to laser energy in all groups and did not break. The breakage of the guidewires occurred after 3 J x 10 Hz (30W) experiment. Group 1a and 1b were different from group 2a, 2b, 4a, and 4b according to Kruskal-Wallis H test. Conclusions: The body parts of the guidewires in all study groups were resistant to laser energy. The tip parts of Zipwire (TM), Sensor (TM) PTFE Nitinol, and Amplatz Super Stiff (TM) guidewire should be kept away from the surgical field when the high power settings of the laser are being used. The body parts of the guidewires can be utilized in the surgical field safely.