Thulium fiber laser lithotripsy: An in vitro analysis of stone fragmentation using a modulated 110-watt Thulium fiber laser at 1.94 µm

✍ Scribed by Nathaniel M. Fried

• Publisher: John Wiley and Sons
• Year: 2005
• Tongue: English
• Weight: 129 KB
• Volume: 37
• Category: Article
• ISSN: 0196-8092
• DOI: 10.1002/lsm.20196

✦ Synopsis

Background and Objectives: The high-power Thulium fiber laser has previously been shown to rapidly vaporize and coagulate soft urinary tissues (e.g., prostate). This is the first preliminary study of a high-power Thulium fiber laser for fragmentation of urinary stones. Study Design/Materials and Methods: A continuouswave, high-power Thulium fiber laser operating at a wavelength of 1.94 mm, was modulated to operate in pulsed mode with an output pulse energy of 1 J through a 300-mmcore silica fiber at a 20 milliseconds pulse length and repetition rate of 10 Hz. The fragmentation time to reduce uric acid (UA) (n ¼ 13) and calcium oxalate monohydrate (COM) (n ¼ 6) stones into particles <2 mm was measured. Results: Mean initial mass of the UA and COM stones measured 860 AE 211 and 763 AE 204 mg. Fragmentation rates measured 388 AE 49 and 25 AE 2 mg/minute. Average time needed to fragment the UA and COM stones into particles <2 mm was 2.25 AE 0.63 and 30.7 AE 8.4 minutes, respectively. Conclusions: The high-power Thulium fiber laser, when operated in pulsed mode, is capable of fragmenting both soft (UA) and hard (COM) urinary stones. The Thulium fiber laser may be useful as a single laser system for use in multiple soft and hard tissue laser ablation applications in urology.