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    An ex vivo experimental study comparing the effects of the holmium: yttrium–aluminum-garnet and thulium fiber lasers on testicular tissue
    (Springer Science and Business Media Deutschland GmbH, 2025) Karaaslan, Mustafa; Yılmaz, Mehmet; Ordu, Melike; Şirin, Mehmet Emin
    The effects of lasers on testicular tissue have not yet been investigated in detail. In this experimental ex vivo study, we aimed to demonstrate and compare the effects of the holmium:yttrium–aluminum-garnet (Ho:YAG) and thulium fiber laser (TFL) lasers on testicular tissue. An ex vivo experiment was performed using calf testes. A 100W Ho:YAG laser and a 60W TFL devices with a setting spectrum at 10–60W, a frequency of 20–40 Hz, energy levels at 0.5–1–1.5 J, and medium pulse duration were tested. Histopathological parameters such as Incision depth (ID), vaporization area (VA), coagulation area (CA), and total laser area (TLA = VA + CA) were evaluated. In testicular tissue without a tunica layer, a statistically significant difference was found in the mean VA and TLA values between the Ho:YAG and TFL, in favor of Ho:YAG (p = 0.003, p = 0.003, respectively). In testicular tissue with a tunica layer, there was a statistically significant difference in mean VA, CA, TLA, ID values between Ho:YAG and TFL, in favor of Ho:YAG (all p < 0.001). At 1.5 J–20 Hz and 1.5 J–40 Hz, we observed that the features indicating tissue dissection, such as VA and ID, were lower in the TFL than those in Ho:YAG, while CA values were higher. VA, CA, TLA, ID values were significantly increased in tissue with tunica compared to non-tunicated tissue in both the Ho:YAG and TFL applications. At 30W and 60W, the penetrative effect of the TFL on tissue was less than that of the Ho:YAG, but its coagulation property was superior. (Table presented.)
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    Comparison of the effects of Ho: YAG laser virtual Basket™ pulse modulation and Thulium fiber laser on kidney tissue – an ex vivo experimental study
    (Springer Science and Business Media Deutschland GmbH, 2024) Emin Şirin, Mehmet; Karaaslan, Mustafa; Ordu, Melike; Yılmaz, Mehmet
    Through an ex vivo experimental study, we aimed to compare the effects of the Ho: YAG laser Virtual Basket (VB™) modulation and a Thulium fiber laser (TFL) on kidney tissue in different environments and using laser configurations. The 100 W Ho: YAG (Cyber Ho, Quanta System, Italy) and 60 W TFL (Fiber Dust, Quanta System, Italy) laser devices were used. The following laser settings were selected: power in the range of 10–60 W, frequency of 20–40 Hz, and energy of 0.5–1–1.5 J. A medium pulse duration of 600 µsec was used for VB™, while short (spdTFL; 50 µsec) and long (lpdTFL; 15,000 µsec) were used for TFL. The tissue’s incision depth (ID), vaporization area (VA), coagulation area (CA), total laser area (TLA = VA + CA), surface section (SS), and lateral effect (LE) were measured. In total, 108 experiments were conducted. No statistically significant difference in mean VA, TLA, ID, LE, or SS was observed between VB™, spdTFL, and lpdTFL in the low-power output group in saline (p > 0.05). However, the mean CA was statistically significantly higher for VB™ (p = 0.005). In saline and high-power output group, the mean VA, CA, TLA, LE, and ID were higher when using lpdTFL than other pulse durations (p = 0.001, p = 0.001, p = 0.001, p = 0.006, and p = 0.001, respectively). Similar to lpdTFL, VB™ may provide controlled dissection and incision as well as haemostasis. At different laser settings, the individual effects of laser properties (such as pulse length, energy and frequency) on tissue may be more significant.
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    Could Testicular Tissue Be a New Arena for the Holmium Laser
    (Cureus, 2023) Karaaslan, Mustafa; Yılmaz, Mehmet; Ordu, Melike; Şirin, Mehmet Emin
    IntroductionWe aimed to observe the effects of holmium:yttrium-aluminum-garnet (Ho:YAG) laser on testicular tissue.MethodsAn ex vivo experiment was conducted using calf testicles. A 100 W laser generator with broad-spectrum settings of 10-80 W, 20-40 Hz, and 0.5-2 1, with a medium pulse duration, was tested. The laser effects on testicular tissues with and without the tunica layer were evaluated histopathologically by calculating the incision depth (ID), vaporization area (VA), coagulation area (CA), and total laser area (TLA=VA+CA) of the specimens.ResultsA total of 48 experiments were conducted. In testicular tissue without a tunica layer, the highest mean ID was determined at 1 1-20 Hz (0.247-0.0208 mm) and with a tunica layer at 2 1-40 Hz (2.673-0.032 mm). In the testicular tissue without a tunica layer, the highest mean VA was determined at 1.5 1-40 Hz (0.029-0.0016 mm(2)) and in tissue with a tunica at 2 1-40 Hz (6.173-0.114 mm(2)). The highest mean TLA in tissue without a tunica was detected at 2 1-20 Hz (0.038-0.0008 mm(2)) and in tissue with a tunica at 2 1-40 Hz (7.292-0.07 mm(2)). The mean ID, VA, CA, and TLA values of all the power outputs used were found to be statistically significantly higher in the testicular tissue with the tunica layer than in that without it (p<0.001).ConclusionThe Ho:YAG laser has different effects on testicular tissue with and without a tunica layer. In testicular tissue without a tunica, the laser's effect was minimal on the surrounding tissue, especially in terms of the ID, VA, and TLA. This minimal effect of the laser can be an advantage in testicular surgery procedures such as testis -sparing surgery (TSS) or testicular sperm extraction (TESE).
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    Effect of Ho:YAG laser on kidney tissue with Virtual Basket™ and Bubble Blast™ pulse modulation: an experimental ex vivo study
    (Springer Science and Business Media Deutschland GmbH, 2024) Şirin, Mehmet Emin; Karaaslan, Mustafa; Ordu, Melike; Yılmaz, Mehmet
    There is a lack of studies in the literature on effects of Virtual Basket™ (VB) and Bubble Blast™ (BB) laser pulse modulations of the Ho:YAG laser on tissue. We aimed to compare the effects of standard modulation (SM), VB, and BB pulse modulations of Ho:YAG laser on kidney tissue. Methods: An ex vivo experiment was conducted using veal kidneys. The Quanta System Cyber Ho 100W laser generator with a broad setting spectrum at 15–80 W, 10–40 Hz, 1.5–2 J, and medium pulse duration were tested. Incision depth (ID), vaporization area (VA), coagulation area (CA), and total laser area (TLA = VA + CA) were evaluated. Histopathological measurement outcomes were grouped as a low-power group (15, 20, and 30 W) and a high-power group (40, 60, and 80 W) according to the power outputs used. Results: A total of 108 experiments were performed. In saline and high-power output (40, 60, 80 W), mean VA, TLA, and ID, histopathological measurements were higher in BB pulse modulation than VB and SM pulse modulations (p: 0.03, p: 0.001, and p: 0.003, respectively). In contrast, mean CA and LE measurements were higher in SM than in VB and BB pulse modulations (p < 0.001 and p < 0.001, respectively). There was no statistically significant difference in mean histopathological measurements of VA, CA, TLA, and ID, among SM, VB, and BB pulse modulations in the low-power output group in saline (p > 0.05). Conclusion: VB can allow controlled dissection, as it does not create a large VA during surgical procedures. BB should be used in a controlled manner in soft tissue surgery due to its strong effect on tissues.
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    Expression of nectin-4 in prostate cancer
    (Expression of nectin-4 in prostate cancer, 2023) Ordu, Melike; Karaaslan, Mustafa; Şirin, Mehmet Emin; Yılmaz, Mehmet
    Nectin-4 is a transmembrane protein belonging to the nectin family of immunoglobulin-like molecules which is found in the placenta and trachea under physiological conditions and its expression has been shown in many cancer types. We aimed to investigate for the 1st time nectin-4 expression in human prostate cancer tissues. METHODS: We retrospectively analyzed the prostate pathology specimens of 82 patients who underwent initial transrectal ultrasound-guided prostate biopsy or transurethral prostate resection and were found to have atypical small acinar proliferation (ASAP) and incidentally prostate cancer. Tissue samples with prostatic cancer were used as a control for alpha-methyla-cyl-CoA racemase (AMACR), and benign prostatic glands in the same tissue provided the negative control. The intensity and extent of nectin-4 expression were determined microscopically using the histochemical scoring system which was defined as the product of the staining intensity (score: 0–3) and percentage of stained cells (0–100) at a given intensity. RESULTS: We conducted immunohistochemical analysis of nectin-4 and AMACR expression in all 82 samples. While AMACR expression was positive in prostate cancer tissues with a GS of <7 (n=24, 100%), 7 (n=18, 100%), and ?8 (n=15, 100%), it was negative in all ASAP samples (n=25, 100%) (p<0.001). Nectin-4 expression was not detected in any of the GS <7, GS 7, or GS ?8 samples but was found in benign prostatic gland tissues and all 25 (100%) ASAP samples (p<0.001). CONCLUSION: We found that nectin-4 was not expressed in prostate cancer tissues but was expressed in ASAP-and benign prostate gland containing tissues. We believe that prospective studies with more patients and samples including radical pros-tatectomy materials will reveal the relationship between nectin-4 and prostate cancer more clearly.