
Proceedings Paper
Holmium:YAG (wavelength=2120 nm) vs. Thulium fiber laser (wavelength=1908 nm) ablation of kidney stones: thresholds, rates, and retropulsionFormat | Member Price | Non-Member Price |
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Paper Abstract
The Holmium:YAG (Ho:YAG) laser lithotriptor is capable of operating at high pulse energies, but its efficient
operation is limited to relatively low pulse rates (~10 Hz) during lithotripsy. On the contrary, the Thulium Fiber
Laser (TFL) is limited to low pulse energies, but can operate at very high pulse rates (up to 1000 Hz). This study
compares stone ablation threshold, ablation rate, and retropulsion effects for different Ho:YAG and TFL operation
modes. The TFL (λ=1908 nm) was operated with pulse energies of 5-35 mJ, 500-μs pulse duration, and pulse rates
of 10-400 Hz. The Ho:YAG laser (λ=2120 nm) was operated with pulse energies of 30-550 mJ, 350-μs pulse
duration, and pulse rate of 10 Hz. Laser energy was delivered through small-core (200-270-μm) optical fibers in
contact mode with human calcium oxalate monohydrate (COM) stones for ablation studies and plaster-of-Paris stone
phantoms for retropulsion studies. The COM stone ablation threshold for Ho:YAG and TFL measured 82.6 J/cm2and 20.8 J/cm2, respectively. Stone retropulsion with Ho:YAG laser increased linearly with pulse energy.
Retropulsion with TFL was minimal at pulse rates < 150 Hz, then rapidly increased at higher pulse rates. For
minimal stone retropulsion, Ho:YAG operation at pulse energies < 175 mJ at 10 Hz, and TFL operation at 35 mJ at
100 Hz is recommended, with both lasers producing comparable ablation rates. Further development of a TFL
operating with both high pulse energies (e.g. 100-200 mJ) and high pulse rates (100-150 Hz) may also provide
higher ablation rates, when retropulsion is not the primary concern.
Paper Details
Date Published: 17 February 2011
PDF: 7 pages
Proc. SPIE 7883, Photonic Therapeutics and Diagnostics VII, 788318 (17 February 2011); doi: 10.1117/12.873942
Published in SPIE Proceedings Vol. 7883:
Photonic Therapeutics and Diagnostics VII
Kenton W. Gregory M.D.; Nikiforos Kollias; Andreas Mandelis; Henry Hirschberg M.D.; Hyun Wook Kang; Anita Mahadevan-Jansen; Brian Jet-Fei Wong M.D.; Justus F. R. Ilgner M.D.; Bodo E. Knudsen M.D.; E. Duco Jansen; Steen J. Madsen; Guillermo J. Tearney; Bernard Choi; Haishan Zeng; Laura Marcu, Editor(s)
PDF: 7 pages
Proc. SPIE 7883, Photonic Therapeutics and Diagnostics VII, 788318 (17 February 2011); doi: 10.1117/12.873942
Show Author Affiliations
Richard L. Blackmon, The Univ. of North Carolina at Charlotte (United States)
Pierce B. Irby, Carolinas Medical Ctr. (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)
Johns Hopkins Medical Institutions (United States)
Published in SPIE Proceedings Vol. 7883:
Photonic Therapeutics and Diagnostics VII
Kenton W. Gregory M.D.; Nikiforos Kollias; Andreas Mandelis; Henry Hirschberg M.D.; Hyun Wook Kang; Anita Mahadevan-Jansen; Brian Jet-Fei Wong M.D.; Justus F. R. Ilgner M.D.; Bodo E. Knudsen M.D.; E. Duco Jansen; Steen J. Madsen; Guillermo J. Tearney; Bernard Choi; Haishan Zeng; Laura Marcu, Editor(s)
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