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Proceedings Paper

Holmium laser lithotripsy of urinary calculi: initial experience with the 200-um holmium laser fiber
Author(s): Marc A. Beaghler; Michael W. Poon; Herbert C. Ruckle; Steven C. Stewart
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Paper Abstract

We performed a pilot evaluation of the 200 micron holmium laser fiber to treat a variety of ureteral and renal calculi. The 200 micron laser fiber has the potential advantage of being more malleable and therefore having increased deflectability compared to larger laser fibers. A total of sixty patients underwent treatment for urinary calculi either primarily or as an adjunct. Thirty-three intrarenal stones and 26 ureteral stones were ureteroscopically treated with the 200 micron holmium laser fiber. Mean stone burden was 12.8 mm for renal stones (range equals 3 - 40 mm) and 7.7 mm for ureteral stones (range 5 - 15 mm). The ability to treat calculi in dependent calices and energy required to fragment calculi were studied. In addition, a bench top study was performed to determine the effect of the 200 micron fiber on active deflection of various flexible ureteroscopes. The bench studies revealed that the 200 micron fiber limited the flexibility of the ureteroscopes from 9 to 43 degrees depending on the ureteroscope. In spite of the limitation demonstrated in the bench top studies, in vivo we found that using the small diameter laser fiber, we could access and treat calculi located within dependent and lower pole calices. In addition, although the 200 micron fiber did inhibit deflection of flexible ureteroscopes, in all cases we were able to obtain access to the lower pole using this fiber.

Paper Details

Date Published: 22 May 1997
PDF: 4 pages
Proc. SPIE 2970, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VII, (22 May 1997); doi: 10.1117/12.275076
Show Author Affiliations
Marc A. Beaghler, Loma Linda Univ. School of Medicine (United States)
Michael W. Poon, Loma Linda Univ. School of Medicine (United States)
Herbert C. Ruckle, Loma Linda Univ. School of Medicine (United States)
Steven C. Stewart, Loma Linda Univ. School of Medicine (United States)

Published in SPIE Proceedings Vol. 2970:
Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VII
R. Rox Anderson; Harvey Lui; Michail M. Pankratov; Kenneth Eugene Bartels; Gerhard J. Mueller; Graham M. Watson; Reza S. Malek; Lawrence S. Bass; Lloyd P. Tate; Hans-Dieter Reidenbach; Kenneth Eugene Bartels; R. Rox Anderson; Lawrence S. Bass; Aaron P. Perlmutter; Kenton W. Gregory; David M. Harris; David M. Harris; Harvey Lui; Reza S. Malek; Gerhard J. Mueller; Michail M. Pankratov; Aaron P. Perlmutter; Hans-Dieter Reidenbach; Lloyd P. Tate; Graham M. Watson, Editor(s)

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