Improving Mechanistic Understanding and Treatment Efficiency of Laser Lithotripsy

提高激光碎石机制的理解和治疗效率

• 批准号: 10019531
• 负责人: PEI ZHONG
• 金额: $ 30.95万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-18 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10019531
• 关键词: Acoustics; Address; Benign; Biomedical Engineering; Biophotonics; Budgets; Clinic; Clinical; Clinical Management; Clinical Treatment; Collaborations; Communication; Development; Devices; Disease; Education; Educational Technology; Emergency department visit; Engineering; Entrepreneurship; Event; Foundations; Frequencies; Future; Genitourinary system; Goals; Growth; Infrastructure; Interdisciplinary Study; Investigation; Kidney; Knowledge; Laser Lithotripsy; Lasers; Lithotripsy; Manufacturer Name; Mechanics; Medical Device; Modality; National Institute of Diabetes and Digestive and Kidney Diseases; Nephrolithiasis; Operative Surgical Procedures; Optics; Outcome; Pain; Patient-Focused Outcomes; Patients; Performance; Physiologic pulse; Recurrence; Repeat Surgery; Reporting; Research; Research Personnel; Research Project Grants; Residual state; Safety; Shock; Surgical Management; System; Talents; Technology; Time; Tissues; Training; Training Programs; Universities; Ureteroscopy; Urinary Calculi; Urogenital Diseases; Urologist; Urology; Work; biomedical scientist; clinical care; cost; engineering design; experience; follow-up; improved; innovation; interest; materials science; mechanical properties; medical specialties; meetings; multidisciplinary; next generation; novel; organizational structure; outreach; patient oriented; photonics; programs; recruit; success; synergism; technological innovation; technology development; technology/technique; urologic; web site

OVERALL: SUMMARY ABSTRACT Nephrolithiasis (or commonly known as urinary stone disease) is a benign but severely painful genitourinary disease that is on the rise and is the second most costly urologic condition in the US at over $2 billion per year. The treatment of nephrolithiasis is shifting away from shock wave lithotripsy (SWL) to intracorporeal laser lithotripsy (LL) via ureteroscopy, but the foundational knowledge of laser-stone-tissue interaction and LL technology has not advanced commensurably with its growing use in clinical care. At present, there is a pressing need for a fundamental and comprehensive investigation of the existing LL technologies and the dissimilar mechanisms of action associated with various modes of LL. Such an effort will be timely and crucial to optimize LL for improved patient-oriented outcomes and long-term surgical management of stone disease. Therefore, the overarching goal of this P20 application is to develop a Center for Urological Laser Technologies (CULT) at Duke University that will synergistically combine the expertise in engineering and urology to better understand the dissimilar laser technologies and techniques used clinically for stone management. This center will focus on a Research Project. The center's team will consist of investigators with expertise in urology, biophotonics, heat transfer, computational mechanics, and materials science to address the challenges faced in advancing laser technologies to treat stone disease. The center's Research Project has two Specific Aims focusing on (1) Characterizing comprehensively the optical, thermal, acoustic, and mechanical properties of kidney and artificial stones of different compositions and investigate the dissimilar mechanisms of stone damage produced by various modes of LL; and (2) Performing an in-depth analysis of laser-induced cavitation bubble dynamics in correlation with stone retropulsion and treatment efficiency produced by different LL devices. The center's Administrative Core will provide infrastructure required to manage the scientific oversight of CULT's Research Project studies and oversee the organizational, budgeting, reporting, outreach, communications, and educational goals of the CULT. CULT's EEP will provide a novel training experience in engineering design and entrepreneurship to the next generation of bioengineers in close collaboration with clinicians interested in benign genitourinary research. Synergies and knowledge created by CULT are expected to propel technological innovation and development in LL systems forward, in collaboration with a leading LL manufacturer Dornier MedTech and other medical device companies, benefitting millions of stone patients worldwide.

总体：摘要 肾结石（或俗称泌尿系结石病）是一种良性但严重疼痛的泌尿生殖系统疾病 该疾病呈上升趋势，是美国第二大昂贵的泌尿系统疾病，每年花费超过 20 亿美元。 肾结石的治疗正在从冲击波碎石术（SWL）转向体内激光 通过输尿管镜碎石术 (LL)，但激光-结石-组织相互作用和 LL 的基础知识 技术的进步并没有与其在临床护理中的日益广泛使用相称。目前，有一个紧迫的任务 需要对现有的 LL 技术和不同的技术进行基础和全面的研究 与各种 LL 模式相关的作用机制。这样的努力对于优化来说是及时且至关重要的 LL 旨在改善以患者为中心的结果和结石病的长期手术治疗。因此， 该 P20 应用程序的总体目标是在杜克大学建立泌尿激光技术中心 (CULT) 大学将协同结合工程和泌尿科的专业知识，以更好地了解 不同的激光技术和临床用于结石管理的技术。该中心将重点关注 研究项目。该中心的团队将由具有泌尿学、生物光子学、热学专业知识的研究人员组成 转移、计算力学和材料科学，以解决推进激光技术所面临的挑战 治疗结石病的技术。该中心的研究项目有两个具体目标，重点是 (1) 全面表征肾脏和人工肾的光学、热学、声学和机械特性 不同成分的石头，并研究不同的石头损坏机制 LL的各种模式； (2) 对激光诱导空化气泡动力学进行深入分析 不同 LL 装置产生的结石后推力和治疗效率的相关性。该中心的 行政核心将提供管理 CULT 研究科学监督所需的基础设施 项目研究并监督组织、预算、报告、外展、沟通和教育 邪教的目标。 CULT 的 EEP 将在工程设计和 与对良性感兴趣的临床医生密切合作，培养下一代生物工程师的创业精神 泌尿生殖研究。 CULT 创造的协同效应和知识有望推动技术发展 与领先的 LL 制造商 Dornier 合作，推进 LL 系统的创新和开发 MedTech等医疗器械公司，造福全球数百万结石患者。