The mechanism of action of the holmium laser lithotripsy is attributed to explosive expanding and imploding
vapor bubbles in association with high-speed water jets creating high mechanical stress and cracking the stone
surface. A good understanding of this mechanism will contribute to the improvement and the safety of clinical
treatments. A new method has been developed to visualize the dynamics of mechanical effects and fluid flow
induced by Holmium laser pulses around the fiber tip and the stone surface. The fiber tip was positioned near the
surface of a stone on a slab of polyacrylamide gel submerged in water. The effects were captured with high
speed imaging at 2000-10000 f/s. The dynamics of the pressure wave after the pulse could be visualized by
observing the optical deformation of a fine line pattern in the background of the water container using digital
subtraction software. This imaging technique provides a good understanding of the mechanical effects
contributing to the effectiveness and safety of lithotripsy and can be used to study the optimal fiber shape and
position towards the stone surface.
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