Optimization of a novel Tm fiber laser lithotripter in terms of stone ablation efficiency and retropulsion reduction

Ilya Yaroslavsky; Victoria Vinnichenko; Tyler McNeill; Anna Novoseltseva; Igor Perchuk; Alexander Vybornov; Gregory Altshuler; Valentin Gapontsev

doi:10.1117/12.2291089

7 February 2018 Optimization of a novel Tm fiber laser lithotripter in terms of stone ablation efficiency and retropulsion reduction

Ilya Yaroslavsky, Victoria Vinnichenko, Tyler McNeill, Anna Novoseltseva, Igor Perchuk, Alexander Vybornov, Gregory Altshuler, Valentin Gapontsev

Author Affiliations +

Proceedings Volume 10468, Therapeutics and Diagnostics in Urology 2018; 104680H (2018) https://doi.org/10.1117/12.2291089
Event: SPIE BiOS, 2018, San Francisco, California, United States

Abstract

Recently, a Thulium (Tm) fiber laser operating at a wavelength of 1940 nm and peak power up to 500 W has been introduced as a promising energy source for laser lithotripsy. Direct comparative studies have demonstrated considerable advantages of Tm fiber laser over the current industry-standard 2100 nm Holmium:YAG (Ho:YAG) device in terms of ablation rate and retropulsion effects. In this work, we investigated avenues of further improving stone ablation efficiency and reducing retropulsion. Specifically, the roles of temporal pulse structure and fiber tip preparation were studied in detail. Experiments were conducted on Bego stone phantoms in an aqueous environment using a computerized 2D stage for controlled scanning of the fiber over the stone surface. High-resolution 3D-enabled optical microscopy was employed to assess both fiber tip damage and stone ablation rate. Retropulsion effects were quantified using a high-speed video camera. Fiber burn back was evaluated as well. Fiber performance could be preserved during prolonged (up to 15 min) procedures when the fiber tip was adequately prepared. Furthermore, the results were compared with available literature for similar experiments performed with the Ho:YAG laser. The data obtained provide an important foundation for optimizing clinical performance of Tm fiber systems for lithotripsy.

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Ilya Yaroslavsky, Victoria Vinnichenko, Tyler McNeill, Anna Novoseltseva, Igor Perchuk, Alexander Vybornov, Gregory Altshuler, and Valentin Gapontsev "Optimization of a novel Tm fiber laser lithotripter in terms of stone ablation efficiency and retropulsion reduction", Proc. SPIE 10468, Therapeutics and Diagnostics in Urology 2018, 104680H (7 February 2018); https://doi.org/10.1117/12.2291089

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