Tags

Type your tag names separated by a space and hit enter

Strike Rate: Analysis of Laser Fiber to Stone Distance During Different Modes of Laser Lithotripsy.
J Endourol. 2020 Jul 31 [Online ahead of print]JE

Abstract

Introduction: Different techniques of laser lithotripsy (fragmentation, dusting, and popcorning) are commonly used during ureteroscopy. The efficiency of a single laser pulse is dependent on minimizing laser fiber-stone distance, yet it has not been reported how often the laser fiber is in contact with the stone during laser lithotripsy. In this study, we sought to measure laser fiber to stone distance using light reflectance for each technique of laser lithotripsy.

Methods:

Continuous light from a 660 nm (red) light-emitting diode (LED) was coupled into a 200 μm fiber using a fiber X-coupler. The LED fiber was positioned immediately next to a 242 μm holmium fiber, and both were passed through the working channel of an ureteroscope. One fiber was used to deliver laser energy to the stone, and the other fiber was used to measure distance based on light reflected from the stone back into the fiber. For fragmentation and dusting experiments, a 5 mm BegoStone was placed into a 20 mm three-dimensional printed caliceal model. For popcorn experiments, 10 BegoStones (3 × 3 × 1.5 mm) were placed in an 11 mm caliceal model and the laser fiber positioned 2 mm away from the stone surface. Data were analyzed using a MATLAB software to report fiber to stone distance at each laser pulse.

Results:

With fragmentation, 52% of laser pulses were delivered when the fiber was within 0.5 mm of the stone compared to 23% and 4% for dusting and popcorning, respectively. Laser pulses delivered when fiber to stone distance was >1 mm (least effective) accounted for 34%, 48%, and >80% of total pulses during fragmentation, dusting, and popcorning, respectively.

Conclusion:

Current methods of laser lithotripsy that rely on fixed firing rates are inefficient, especially for the popcorn technique. These data highlight areas for improvement by appropriately gating pulse delivery to maximize lithotripsy effect for each pulse fired.

Authors+Show Affiliations

Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA.Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA.Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA. Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32631082

Citation

Aldoukhi, Ali H., et al. "Strike Rate: Analysis of Laser Fiber to Stone Distance During Different Modes of Laser Lithotripsy." Journal of Endourology, 2020.
Aldoukhi AH, Hall TL, Ghani KR, et al. Strike Rate: Analysis of Laser Fiber to Stone Distance During Different Modes of Laser Lithotripsy. J Endourol. 2020.
Aldoukhi, A. H., Hall, T. L., Ghani, K. R., & Roberts, W. W. (2020). Strike Rate: Analysis of Laser Fiber to Stone Distance During Different Modes of Laser Lithotripsy. Journal of Endourology. https://doi.org/10.1089/end.2020.0298
Aldoukhi AH, et al. Strike Rate: Analysis of Laser Fiber to Stone Distance During Different Modes of Laser Lithotripsy. J Endourol. 2020 Jul 31; PubMed PMID: 32631082.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Strike Rate: Analysis of Laser Fiber to Stone Distance During Different Modes of Laser Lithotripsy. AU - Aldoukhi,Ali H, AU - Hall,Timothy L, AU - Ghani,Khurshid R, AU - Roberts,William W, Y1 - 2020/07/31/ PY - 2020/7/8/pubmed PY - 2020/7/8/medline PY - 2020/7/8/entrez KW - dusting KW - fragmentation KW - laser KW - laser lithotripsy KW - ureteroscopy JF - Journal of endourology JO - J. Endourol. N2 - Introduction: Different techniques of laser lithotripsy (fragmentation, dusting, and popcorning) are commonly used during ureteroscopy. The efficiency of a single laser pulse is dependent on minimizing laser fiber-stone distance, yet it has not been reported how often the laser fiber is in contact with the stone during laser lithotripsy. In this study, we sought to measure laser fiber to stone distance using light reflectance for each technique of laser lithotripsy. Methods: Continuous light from a 660 nm (red) light-emitting diode (LED) was coupled into a 200 μm fiber using a fiber X-coupler. The LED fiber was positioned immediately next to a 242 μm holmium fiber, and both were passed through the working channel of an ureteroscope. One fiber was used to deliver laser energy to the stone, and the other fiber was used to measure distance based on light reflected from the stone back into the fiber. For fragmentation and dusting experiments, a 5 mm BegoStone was placed into a 20 mm three-dimensional printed caliceal model. For popcorn experiments, 10 BegoStones (3 × 3 × 1.5 mm) were placed in an 11 mm caliceal model and the laser fiber positioned 2 mm away from the stone surface. Data were analyzed using a MATLAB software to report fiber to stone distance at each laser pulse. Results: With fragmentation, 52% of laser pulses were delivered when the fiber was within 0.5 mm of the stone compared to 23% and 4% for dusting and popcorning, respectively. Laser pulses delivered when fiber to stone distance was >1 mm (least effective) accounted for 34%, 48%, and >80% of total pulses during fragmentation, dusting, and popcorning, respectively. Conclusion: Current methods of laser lithotripsy that rely on fixed firing rates are inefficient, especially for the popcorn technique. These data highlight areas for improvement by appropriately gating pulse delivery to maximize lithotripsy effect for each pulse fired. SN - 1557-900X UR - https://www.unboundmedicine.com/medline/citation/32631082/Strike_Rate:_Analysis_of_Laser_Fiber_to_Stone_Distance_During_Different_Modes_of_Laser_Lithotripsy_ L2 - https://www.liebertpub.com/doi/10.1089/end.2020.0298?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.