An integrated fiber and stone basket device for use in Thulium fiber laser lithotripsy

Christopher R. Wilson, Thomas C. Hutchens, Luke A. Hardy, Pierce B. Irby, Nathaniel M. Fried

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

The Thulium fiber laser (TFL) is being explored as an alternative laser lithotripter to the Holmium:YAG laser. The TFL's superior near-single mode beam profile enables higher power transmission through smaller fibers with reduced proximal fiber tip damage. Recent studies have also reported that attaching hollow steel tubing to the distal fiber tip decreases fiber degradation and burn-back without compromising stone ablation rates. However, significant stone retropulsion was observed, which increased with pulse rate. In this study, the hollow steel tip fiber design was integrated with a stone basket to minimize stone retropulsion during ablation. A device was constructed consisting of a 100-μm-core, 140-μm-OD silica fiber outfitted with 5-mm-long stainless steel tubing at the distal tip, and integrated with a 1.3-Fr (0.433-mm-OD) disposable nitinol wire basket, to form an overall 1.9-Fr (0.633-mm- OD) integrated device. This compact design may provide several potential advantages including increased flexibility, higher saline irrigation rates through the ureteroscope working channel, and reduced fiber tip degradation compared to separate fiber and stone basket manipulation. TFL pulse energy of 31.5 mJ with 500 μs pulse duration and pulse rate of 500 Hz was delivered through the integrated fiber/basket device in contact with human uric acid stones, ex vivo. TFL stone ablation rates measured 1.5 ± 0.2 mg/s, comparable to 1.7 ± 0.3 mg/s (P > 0.05) using standard bare fiber tips separately with a stone basket. With further development, this device may be useful for minimizing stone retropulsion, thus enabling more efficient TFL lithotripsy at higher pulse rates.

Original languageEnglish (US)
Title of host publicationProgress in Biomedical Optics and Imaging - Proceedings of SPIE
PublisherSPIE
Volume8926
ISBN (Print)9780819498397
DOIs
StatePublished - 2014
EventPhotonic Therapeutics and Diagnostics X - San Francisco, CA, United States
Duration: Feb 1 2014Feb 2 2014

Other

OtherPhotonic Therapeutics and Diagnostics X
CountryUnited States
CitySan Francisco, CA
Period2/1/142/2/14

Keywords

  • Ablation
  • Basket
  • Fiber laser
  • Fragmentation
  • Lithotripsy
  • Thulium
  • Urinary stones

ASJC Scopus subject areas

  • Atomic and Molecular Physics, and Optics
  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Radiology Nuclear Medicine and imaging

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