Erbium: YAG laser ablation of urethral and ureteral tissues

Nathaniel M. Fried; Gary M. Long

doi:10.1117/12.430657

Erbium: YAG laser ablation of urethral and ureteral tissues

Nathaniel M. Fried, Gary M. Long

School of Medicine

Research output: Chapter in Book/Report/Conference proceeding › Conference contribution

6 Scopus citations

Abstract

Cold knife incision of urological strictures results in a high rate of stricture recurrence. This study compares Ho:YAG and Er:YAG lasers for precise incision of urethral and ureteral tissues. Laser ablation was performed using Ho:YAG (λ=2.1 μm) and Er:YAG (λ=2.94 μm) lasers operating in long-pulse mode (τ_p = 300 μs). Ho:YAG laser radiation was delivered through low-OH fibers while Er:YAG laser radiation was delivered through germanium oxide or sapphire fibers. Ex vivo canine and porcine tissue samples were placed in saline, and perforation thresholds, ablation rates, and histological thermal damage measurements were recorded. Optical fiber damage thresholds during contact ablation were also studied. The Ho:YAG and Er:YAG lasers perforated thick tissue samples at thresholds of 350 J/cm² and 65 J/cm², respectively, with peripheral thermal damage zones measuring 290 ± 30 μm and 30 ± 10 μm, respectively. Germanium oxide fibers were damaged at energies greater than 150 mJ/pulse (80 J/cm²), but no damage to sapphire fibers was observed at energies up to 450 mJ/pulse (350 J/cm²). The Er:YAG laser efficiently ablates urethral and ureteral tissues while reducing peripheral thermal damage by an order of magnitude over the Ho:YAG laser. In vivo animal studies for Er:YAG laser incision of strictures are planned with comparison to cold knife incision.

Original language	English (US)
Title of host publication	Proceedings of SPIE - The International Society for Optical Engineering
Editors	W.T.W. Riese, K.E. Bartels, L.S. Bass, K.W. Gregory
Pages	122-127
Number of pages	6
Volume	4609
DOIs	https://doi.org/10.1117/12.430657
State	Published - 2002
Event	Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XII - San Jose, CA, United States Duration: Jan 19 2002 → Jan 22 2002

Other

Other	Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XII
Country/Territory	United States
City	San Jose, CA
Period	1/19/02 → 1/22/02

Keywords

Erbium
Germanium oxide
Holmium
Laser ablation
Optical fibers
Sapphire
Strictures

ASJC Scopus subject areas

Electrical and Electronic Engineering
Condensed Matter Physics

Access to Document

10.1117/12.430657

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Fried, NM & Long, GM 2002, Erbium: YAG laser ablation of urethral and ureteral tissues. in WTW Riese, KE Bartels, LS Bass & KW Gregory (eds), Proceedings of SPIE - The International Society for Optical Engineering. vol. 4609, pp. 122-127, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XII, San Jose, CA, United States, 1/19/02. https://doi.org/10.1117/12.430657

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abstract = "Cold knife incision of urological strictures results in a high rate of stricture recurrence. This study compares Ho:YAG and Er:YAG lasers for precise incision of urethral and ureteral tissues. Laser ablation was performed using Ho:YAG (λ=2.1 μm) and Er:YAG (λ=2.94 μm) lasers operating in long-pulse mode (τp = 300 μs). Ho:YAG laser radiation was delivered through low-OH fibers while Er:YAG laser radiation was delivered through germanium oxide or sapphire fibers. Ex vivo canine and porcine tissue samples were placed in saline, and perforation thresholds, ablation rates, and histological thermal damage measurements were recorded. Optical fiber damage thresholds during contact ablation were also studied. The Ho:YAG and Er:YAG lasers perforated thick tissue samples at thresholds of 350 J/cm2 and 65 J/cm2, respectively, with peripheral thermal damage zones measuring 290 ± 30 μm and 30 ± 10 μm, respectively. Germanium oxide fibers were damaged at energies greater than 150 mJ/pulse (80 J/cm2), but no damage to sapphire fibers was observed at energies up to 450 mJ/pulse (350 J/cm2). The Er:YAG laser efficiently ablates urethral and ureteral tissues while reducing peripheral thermal damage by an order of magnitude over the Ho:YAG laser. In vivo animal studies for Er:YAG laser incision of strictures are planned with comparison to cold knife incision.",

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AB - Cold knife incision of urological strictures results in a high rate of stricture recurrence. This study compares Ho:YAG and Er:YAG lasers for precise incision of urethral and ureteral tissues. Laser ablation was performed using Ho:YAG (λ=2.1 μm) and Er:YAG (λ=2.94 μm) lasers operating in long-pulse mode (τp = 300 μs). Ho:YAG laser radiation was delivered through low-OH fibers while Er:YAG laser radiation was delivered through germanium oxide or sapphire fibers. Ex vivo canine and porcine tissue samples were placed in saline, and perforation thresholds, ablation rates, and histological thermal damage measurements were recorded. Optical fiber damage thresholds during contact ablation were also studied. The Ho:YAG and Er:YAG lasers perforated thick tissue samples at thresholds of 350 J/cm2 and 65 J/cm2, respectively, with peripheral thermal damage zones measuring 290 ± 30 μm and 30 ± 10 μm, respectively. Germanium oxide fibers were damaged at energies greater than 150 mJ/pulse (80 J/cm2), but no damage to sapphire fibers was observed at energies up to 450 mJ/pulse (350 J/cm2). The Er:YAG laser efficiently ablates urethral and ureteral tissues while reducing peripheral thermal damage by an order of magnitude over the Ho:YAG laser. In vivo animal studies for Er:YAG laser incision of strictures are planned with comparison to cold knife incision.

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KW - Optical fibers

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ER -

Erbium: YAG laser ablation of urethral and ureteral tissues

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Keywords

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