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Proceedings Paper

A tapered distal fiber tip for thulium fiber laser lithotripsy
Author(s): Richard L. Blackmon; Pierce B. Irby; Nathaniel M. Fried
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Paper Abstract

The Thulium fiber laser has recently been tested as a potential alternative to the Holmium:YAG laser for lithotripsy. This study explores use of a short taper for expanding the Thulium fiber laser beam at the distal tip of a small-core fiber. Thulium fiber laser radiation with a wavelength of 1908 nm, 10 Hz pulse rate, 70 mJ pulse energy, and 1-ms pulse duration was delivered through a 2-m-length fiber with 150-μm-input-end, 300-μm-output-end, and 5-mmlength taper, in contact with human uric acid (UA) and calcium oxalate monohydrate (COM) stones, ex vivo (n=10 each). Stone mass loss, stone crater depths, fiber transmission losses, fiber burn-back, irrigation rates, and deflection through a flexible ureteroscope were measured for the above tapered fiber and compared with conventional fibers. After delivery of 1800 pulses through the tapered fiber, mass loss measured 12.7 ± 2.6 mg for UA and 7.2 ± 0.8 mg COM stones, comparable to conventional 100-μm-core fibers (12.6 ± 2.5 mg for UA and 6.8 ± 1.7 mg for COM stones). No transmission losses or burn-back occurred for the tapered fiber after 36,000 pulses, while a conventional 150-μm fiber experienced significant tip degradation after only 1800 pulses. High irrigation rates were measured with the tapered fiber inserted through the working port of an ureteroscope, without hindering ureteroscope deflection, mimicking that of conventional 150 ìm fibers. The short tapered distal fiber tip allows expansion of the laser beam, resulting in decreased fiber tip damage compared to conventional small-core fibers, without compromising fiber bending, stone vaporization efficiency, or irrigation rates.

Paper Details

Date Published: 2 March 2010
PDF: 7 pages
Proc. SPIE 7548, Photonic Therapeutics and Diagnostics VI, 75481F (2 March 2010); doi: 10.1117/12.840960
Show Author Affiliations
Richard L. Blackmon, 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)
Johns Hopkins Medical Institutions (United States)

Published in SPIE Proceedings Vol. 7548:
Photonic Therapeutics and Diagnostics VI
Anita Mahadevan-Jansen; Andreas Mandelis; Brian Jet-Fei Wong M.D.; Nikiforos Kollias; Henry Hirschberg M.D.; Kenton W. Gregory M.D.; Reza S. Malek; E. Duco Jansen; Guillermo J. Tearney; Steen J. Madsen; Bernard Choi; Justus F. R. Ilgner; Haishan Zeng; Laura Marcu, Editor(s)

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