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Proceedings Paper

Characterization of a 50-um-core optical fiber for potential use in Thulium fiber laser lithotripsy
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Paper Abstract

Our laboratory is currently studying the Thulium fiber laser (TFL) as a potential alternative laser lithotripter to the standard clinical Holmium:YAG laser. We have previously demonstrated efficient coupling of TFL energy into fibers as small as 100-μm-core-diameter without damage to the proximal end. Although smaller fibers have greater tendency to degrade at the distal tip during lithotripsy, fiber diameters (≤ 200 μm) have been shown to increase saline irrigation rates through the working channel of a flexible ureteroscope, maximize ureteroscope deflection, and reduce stone retropulsion during laser lithotripsy. In this study, a 50-μm-core-diameter, 85-μm-outer-diameter fiber is characterized for TFL ablation of human calcium oxalate monohydrate urinary stones, ex vivo. The stone ablation rate was measured to be 70 ± 22 μg/s for 35-mJ-pulse-energy, 500-μs-pulse-duration, and 50-Hz-pulse-rate. The ureteroscope working channel flow rate including the 50-μm fiber decreased by only 10% with no impairment of ureteroscope deflection. The fiber delivered up to 15.4 ± 5.9 W under extreme bending (5-mm-radius) conditions. Stone retropulsion and fiber burn-back averaged 201 ± 336 and 3000 ± 2600 μm, respectively, after 2 minutes. With further development, Thulium fiber laser lithotripsy using ultra-small, 50-μm-core fibers may introduce new integration and miniaturization possibilities and potentially provide an alternatiμe to conventional Holmium:YAG laser lithotripsy using larger fibers.

Paper Details

Date Published: 4 March 2014
PDF: 10 pages
Proc. SPIE 8926, Photonic Therapeutics and Diagnostics X, 89261F (4 March 2014); doi: 10.1117/12.2035556
Show Author Affiliations
Richard L. Blackmon, The Univ. of North Carolina at Charlotte (United States)
Thomas C. Hutchens, The Univ. of North Carolina at Charlotte (United States)
Luke A. Hardy, 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)
Carolinas Medical Ctr. (United States)
Johns Hopkins Medical Institutions (United States)

Published in SPIE Proceedings Vol. 8926:
Photonic Therapeutics and Diagnostics X
Bernard Choi; Hyun Wook Kang; Brian J. F. Wong M.D.; Guillermo J. Tearney M.D.; Andreas Mandelis; Nikiforos Kollias; Kenton W. Gregory M.D.; Justus F. Ilgner M.D.; Haishan Zeng; Laura Marcu, Editor(s)

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