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Proceedings Paper

Fragmentation and dusting of large kidney stones using compact, air-cooled, high peak power, 1940-nm, Thulium fiber laser
Author(s): Luke A. Hardy; David A. Gonzalez; Pierce B. Irby; Nathaniel M. Fried
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Paper Abstract

Previous Thulium fiber laser lithotripsy (TFL) studies were limited to a peak power of 70 W (35 mJ / 500 μs), requiring operation in dusting mode with low pulse energy (35 mJ) and high pulse rate (300 Hz). In this study, a novel, compact, air-cooled, TFL capable of operating at up to 500 W peak power, 50 W average power, and 2000 Hz, was tested. The 1940-nm TFL was used with pulse duration (500 μs), average power (10 W), and fiber (270- μm-core) fixed, while pulse energy and pulse rate were changed. A total of 23 large uric acid (UA) stones and 16 large calcium oxalate monohydrate (COM) stones were each separated into 3 modes (Group 1-“Dusting”- 33mJ/300Hz; Group 2-“Fragmentation”-200mJ/50Hz; Group 3-“Dual mode”-Fragmentation then Dusting). The fiber was held manually in contact with stone on a 2-mm-mesh sieve submerged in a flowing saline bath. UA ablation rates were 2.3±0.8, 2.3±0.2, and 4.4±0.8 mg/s and COM ablation rates were 0.4±0.1, 1.0±0.1, and 0.9±0.4 mg/s, for Groups 1, 2, and 3. Dual mode provided 2x higher UA ablation rates than other modes. COM ablation threshold is 3x higher than UA, so dusting provided lower COM ablation rates than other modes. Future studies will explore higher average laser power than 10 W for rapid TFL ablation of large stones.

Paper Details

Date Published: 7 February 2018
PDF: 5 pages
Proc. SPIE 10468, Therapeutics and Diagnostics in Urology 2018, 104680O (7 February 2018);
Show Author Affiliations
Luke A. Hardy, The Univ. of North Carolina at Charlotte (United States)
David A. Gonzalez, 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. 10468:
Therapeutics and Diagnostics in Urology 2018
Hyun Wook Kang; Kin Foong Chan, Editor(s)

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