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Proceedings Paper

Thulium fiber laser lithotripsy using small spherical distal fiber tips
Author(s): Christopher R. Wilson; Luke A. Hardy; Joshua D. Kennedy; Pierce B. Irby; Nathaniel M. Fried
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Paper Abstract

This study tests a 100-μm-core fiber with 300-μm-diameter ball tip during Thulium fiber laser (TFL) lithotripsy. The TFL was operated at 1908 nm wavelength with 35-mJ pulse energy, 500-μs pulse duration, and 300-Hz pulse rate. Calcium oxalate/phosphate stone samples were weighed, laser procedure times measured, and ablation rates calculated for ball tip fibers, with comparison to bare tip fibers. Photographs of ball tips were taken before and after each procedure to observe ball tip degradation and determine number of procedures completed before need to replace fiber. Saline irrigation rates and ureteroscope deflection were measured with and without TFL fiber present. There was no statistical difference (P > 0.05) between stone ablation rates for single-use ball tip fiber (1.3 ± 0.4 mg/s) (n=10), multiple-use ball tip fiber (1.3 ± 0.5 mg/s) (n=44), and conventional single-use bare tip fibers (1.3 ± 0.2 mg/s) (n=10). Ball tip durability varied widely, but fibers averaged > 4 stone procedures before decline in stone ablation rates due to mechanical damage at front surface of ball tip. The small fiber diameter did not impact ureteroscope deflection or saline flow rates. The miniature ball tip fiber may provide a cost-effective design for safe fiber insertion through the ureteroscope working channel and the ureter without risk of scope damage or tissue perforation, and without compromising stone ablation efficiency during TFL ablation of kidney stones.

Paper Details

Date Published: 29 February 2016
PDF: 5 pages
Proc. SPIE 9689, Photonic Therapeutics and Diagnostics XII, 96891G (29 February 2016); doi: 10.1117/12.2207941
Show Author Affiliations
Christopher R. Wilson, The Univ. of North Carolina at Charlotte (United States)
Luke A. Hardy, The Univ. of North Carolina at Charlotte (United States)
Joshua D. Kennedy, The Univ. of North Carolina at Charlotte (United States)
Pierce B. Irby, Carolinas Medical Ctr. (United States)
Nathaniel M. Fried, The Univ. of North Carolina at Charlotte (United States)
Carolinas Medical Ctr. (United States)

Published in SPIE Proceedings Vol. 9689:
Photonic Therapeutics and Diagnostics XII
Hyun Wook Kang; Guillermo J. Tearney; Melissa C. Skala; Bernard Choi; Andreas Mandelis; Brian J. F. Wong; Justus F. Ilgner; Nikiforos Kollias; Paul J. Campagnola; Kenton W. Gregory; Laura Marcu; Haishan Zeng, Editor(s)

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