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Variable Pulse Duration From a New Holmium:YAG Laser: The Effect on Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model.
Urology 2017; 103:47-51U

Abstract

OBJECTIVE

To more clearly define the efficiency and potential benefits of variable pulse-width laser technology for ureteroscopic lithotripsy, we performed comparative in vitro evaluations assessing stone comminution, laser fiber tip degradation, and stone retropulsion.

METHODS

All experiments were conducted using a Swiss LaserClast Holmium:YAG laser (Electro Medical Systems, Nyon, Switzerland) with adjustable pulse duration (300 µs-1500 µs). To assess comminution efficiency and fiber tip degradation, a "dusting" model was employed; the laser fiber tip was moved by a 3-dimensional positioning system in a spiral motion across a flat BegoStone surface submerged in water. Comminution efficiency was measured as the loss of stone mass while fiber tip degradation was measured simultaneously. The same laser and fiber were used in a pendulum model to measure stone retropulsion with a high-speed resolution camera.

RESULTS

In our dusting model, comminution was significantly greater at high energy (2 J/5 Hz). At the high energy setting, comminution was significantly greater with long pulse duration than short pulse, although this difference was not seen at the high frequency setting (1 J/10 Hz). Tip degradation was increased at high energy settings and was even more pronounced with short pulse duration than long pulse. Short pulse duration caused far more retropulsion than the long pulse setting.

CONCLUSION

In an in vitro dusting model, a longer laser pulse duration provides effective stone comminution with the advantage of reducing laser fiber tip degradation and stone retropulsion.

Authors+Show Affiliations

Division of Urologic Surgery, Duke University Medical Center, Durham, NC. Electronic address: Daniel.wollin@duke.edu.Division of Urologic Surgery, Duke University Medical Center, Durham, NC.Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC.Division of Urologic Surgery, Duke University Medical Center, Durham, NC.Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC.Division of Urologic Surgery, Duke University Medical Center, Durham, NC.Division of Urologic Surgery, Duke University Medical Center, Durham, NC.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28089885

Citation

Wollin, Daniel A., et al. "Variable Pulse Duration From a New Holmium:YAG Laser: the Effect On Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model." Urology, vol. 103, 2017, pp. 47-51.
Wollin DA, Ackerman A, Yang C, et al. Variable Pulse Duration From a New Holmium:YAG Laser: The Effect on Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model. Urology. 2017;103:47-51.
Wollin, D. A., Ackerman, A., Yang, C., Chen, T., Simmons, W. N., Preminger, G. M., & Lipkin, M. E. (2017). Variable Pulse Duration From a New Holmium:YAG Laser: The Effect on Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model. Urology, 103, pp. 47-51. doi:10.1016/j.urology.2017.01.007.
Wollin DA, et al. Variable Pulse Duration From a New Holmium:YAG Laser: the Effect On Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model. Urology. 2017;103:47-51. PubMed PMID: 28089885.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Variable Pulse Duration From a New Holmium:YAG Laser: The Effect on Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model. AU - Wollin,Daniel A, AU - Ackerman,Anika, AU - Yang,Chen, AU - Chen,Tony, AU - Simmons,Walter Neal, AU - Preminger,Glenn M, AU - Lipkin,Michael E, Y1 - 2017/01/16/ PY - 2016/11/30/received PY - 2017/01/03/revised PY - 2017/01/05/accepted PY - 2017/1/17/pubmed PY - 2018/6/19/medline PY - 2017/1/17/entrez SP - 47 EP - 51 JF - Urology JO - Urology VL - 103 N2 - OBJECTIVE: To more clearly define the efficiency and potential benefits of variable pulse-width laser technology for ureteroscopic lithotripsy, we performed comparative in vitro evaluations assessing stone comminution, laser fiber tip degradation, and stone retropulsion. METHODS: All experiments were conducted using a Swiss LaserClast Holmium:YAG laser (Electro Medical Systems, Nyon, Switzerland) with adjustable pulse duration (300 µs-1500 µs). To assess comminution efficiency and fiber tip degradation, a "dusting" model was employed; the laser fiber tip was moved by a 3-dimensional positioning system in a spiral motion across a flat BegoStone surface submerged in water. Comminution efficiency was measured as the loss of stone mass while fiber tip degradation was measured simultaneously. The same laser and fiber were used in a pendulum model to measure stone retropulsion with a high-speed resolution camera. RESULTS: In our dusting model, comminution was significantly greater at high energy (2 J/5 Hz). At the high energy setting, comminution was significantly greater with long pulse duration than short pulse, although this difference was not seen at the high frequency setting (1 J/10 Hz). Tip degradation was increased at high energy settings and was even more pronounced with short pulse duration than long pulse. Short pulse duration caused far more retropulsion than the long pulse setting. CONCLUSION: In an in vitro dusting model, a longer laser pulse duration provides effective stone comminution with the advantage of reducing laser fiber tip degradation and stone retropulsion. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/28089885/Variable_Pulse_Duration_From_a_New_Holmium:YAG_Laser:_The_Effect_on_Stone_Comminution_Fiber_Tip_Degradation_and_Retropulsion_in_a_Dusting_Model_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(17)30032-8 DB - PRIME DP - Unbound Medicine ER -