{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T21:56:30Z","timestamp":1791755790690,"version":"4.3.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction and Objectives:<\/jats:title>\n                    <jats:p>\n                      Conventional renal stone dusting is challenging; the holmium (Ho:YAG) laser and holmium with\n                      <jats:italic toggle=\"yes\">MOSES<\/jats:italic>\n                      effect (Ho:YAG-\n                      <jats:italic toggle=\"yes\">MOSES<\/jats:italic>\n                      ) fail to uniformly produce fragments \u2264100\u2009\u03bcm (i.e., dust). The superpulse thulium fiber laser (sTFL) may more effectively render uroliths into \u201cdust,\u201d and may thus improve stone-free rates. Accordingly, we performed\n                      <jats:italic toggle=\"yes\">ex vivo<\/jats:italic>\n                      evaluations with all three laser modalities, assessing stone fragments and stone clearance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Seventy-two\n                      <jats:italic toggle=\"yes\">ex vivo<\/jats:italic>\n                      porcine kidney-ureter models were divided into 12 groups of 6: laser type (Ho:YAG, Ho:YAG-\n                      <jats:italic toggle=\"yes\">MOSES<\/jats:italic>\n                      , sTFL), ureteroscope with and without applied suction, and the presence or absence of a 14F ureteral access sheath (UAS). Calcium oxalate stones were preweighed and implanted into each kidney via a pyelotomy. Stones were treated at 16W using dusting settings of 0.4J\u2009\u00d7\u200940Hz (Ho:YAG), 0.2J\u2009\u00d7\u200980Hz (Ho:YAG-\n                      <jats:italic toggle=\"yes\">MOSES<\/jats:italic>\n                      ), and 0.2J\u2009\u00d7\u200980Hz (sTFL) for up to 20 minutes. No stone basketing was performed. Kidneys were bivalved and residual fragments were collected, dried, weighed, and sieved to determine fragment size and stone clearance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Initial stone mass (mg), procedure time (seconds), and laser energy expenditure (kJ) were similar in all 12 groups. The greatest stone clearance was seen with sTFL + suction + UAS (94%) compared with a conventional technique (Ho:YAG + no suction + no UAS) (65%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01). The use of sTFL provided greater stone clearance than Ho:YAG or Ho:YAG-\n                      <jats:italic toggle=\"yes\">MOSES<\/jats:italic>\n                      . Aspiration improved stone clearance for sTFL (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.01), but not for Ho:YAG or Ho:YAG-\n                      <jats:italic toggle=\"yes\">MOSES<\/jats:italic>\n                      , consistent with the creation of smaller fragments with sTFL. Presence of a 14F UAS improved stone clearance in all scenarios (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      In this\n                      <jats:italic toggle=\"yes\">ex vivo<\/jats:italic>\n                      study, stone clearance was optimized under the following conditions: sTFL, 14F UAS, and aspiration. This combination resulted in 94% of stone fragments being cleared; the 6% remaining fragments were all &lt;2\u2009mm. In all scenarios, deployment of a 14F UAS improved stone clearance.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/end.2021.0544","type":"journal-article","created":{"date-parts":[[2021,10,23]],"date-time":"2021-10-23T10:50:19Z","timestamp":1634986219000},"page":"499-507","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["<i>Ex Vivo<\/i>\n                    Renal Stone Dusting: Impact of Laser Modality, Ureteral Access Sheath, and Suction on Total Stone Clearance"],"prefix":"10.1177","volume":"36","author":[{"given":"Pengbo","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Urology, University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1368-8786","authenticated-orcid":false,"given":"Akhil","family":"Peta","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Brevik","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael B.","family":"Arada","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maged","family":"Ayad","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew S.","family":"Afyouni","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Limfueco","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Palma","sequence":"additional","affiliation":[{"name":"Biostatistics, Epidemiology &amp; Research Design Unit, Institute for Clinical and Translational Science, University of California, Irvine, Irvine, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshan M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Landman","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph V.","family":"Clayman","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,4,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-017-1030-x"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2017.00057"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-020-03178-z"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2010.06.056"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.05.021"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2019.0012"},{"key":"e_1_3_3_8_2","doi-asserted-by":"crossref","unstructured":"Talati J Tiselius H-G Albala DM et al. eds. 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