Proximal fiber tip damage during Holmium:YAG and thulium fiber laser ablation of kidney stones

Christopher R. Wilson; Luke A. Hardy; Pierce B. Irby M.D.; Nathaniel M. Fried

doi:10.1117/12.2207895

29 February 2016 Proximal fiber tip damage during Holmium:YAG and thulium fiber laser ablation of kidney stones

Christopher R. Wilson, Luke A. Hardy, Pierce B. Irby M.D., Nathaniel M. Fried

Proceedings Volume 9689, Photonic Therapeutics and Diagnostics XII; 96891Q (2016) https://doi.org/10.1117/12.2207895
Event: SPIE BiOS, 2016, San Francisco, California, United States

Abstract

The Thulium fiber laser (TFL) is being studied as an alternative to Holmium:YAG laser for lithotripsy. TFL beam originates within an 18-μm-core thulium doped silica fiber, and its near single mode, Gaussian beam profile enables transmission of higher laser power through smaller fibers than possible during Holmium laser lithotripsy. This study examines whether TFL beam profile also reduces proximal fiber tip damage compared to Holmium laser multimodal beam. TFL beam at wavelength of 1908 nm was coupled into 105-μm-core silica fibers, with 35-mJ energy, 500-μs pulse duration, and pulse rates of 50-500 Hz. For each pulse rate, 500,000 pulses were delivered. Magnified images of proximal fiber surfaces were taken before and after each trial. For comparison, 20 single-use, 270-μm-core fibers were collected after clinical Holmium laser lithotripsy procedures using standard settings (600 mJ, 350 μs, 6 Hz). Total laser energy, number of laser pulses, and laser irradiation time were recorded, and fibers were rated for damage. For TFL studies, output power was stable, and no proximal fiber damage was observed after delivery of 500,000 pulses at settings up to 35 mJ, 500 Hz, and 17.5 W average power. In contrast, confocal microscopy images of fiber tips after Holmium lithotripsy showed proximal fiber tip degradation in all 20 fibers. The proximal fiber tip of a 105-μm-core fiber transmitted 17.5 W of TFL power without degradation, compared to degradation of 270-μm-core fibers after transmission of 3.6 W of Holmium laser power. The smaller and more uniform TFL beam profile may improve fiber lifetime, and potentially reduce costs for the surgical disposables as well.

Citation Download Citation

Christopher R. Wilson, Luke A. Hardy, Pierce B. Irby M.D., and Nathaniel M. Fried "Proximal fiber tip damage during Holmium:YAG and thulium fiber laser ablation of kidney stones", Proc. SPIE 9689, Photonic Therapeutics and Diagnostics XII, 96891Q (29 February 2016); https://doi.org/10.1117/12.2207895

ACCESS THE FULL ARTICLE

INSTITUTIONAL
Select your institution to access the SPIE Digital Library.

SELECT YOUR INSTITUTION

PERSONAL
Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.

PERSONAL SIGN IN

No SPIE Account? Create one

PURCHASE THIS CONTENT

SUBSCRIBE TO DIGITAL LIBRARY

50 downloads per 1-year subscription

Members: $195

Non-members: $335 ADD TO CART

25 downloads per 1 - year subscription

Members: $145

Non-members: $250 ADD TO CART

PURCHASE SINGLE ARTICLE

Includes PDF, HTML & Video, when available

Members: $17.00

Non-members: $21.00 ADD TO CART

PROCEEDINGS
6 PAGES

DOWNLOAD PAPER SAVE TO MY LIBRARY

GET CITATION

RIGHTS & PERMISSIONS

Get copyright permission Get copyright permission on Copyright Marketplace

KEYWORDS

Fiber lasers

Holmium

Laser therapeutics

Confocal microscopy

Laser lithotripsy

Connectors

YAG lasers

Show All Keywords

Keywords/Phrases

Search In:

Publication Years