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Urinary calculus fragmentation during Ho: YAG and Er:YAG lithotripsy
Ho Lee1, Hyun Wook Kang, Joel M H Teichman
1Harvard Medical School, Wellman Center for Photomedicine, Massachusetts General Hospital, BHX 630, 50 Blossom Street, Boston, 02114, USA. hlee14@partners.org
Lasers in Surgery and Medicine
|November 18, 2005
Summary
The Erbium:YAG (Er:YAG) laser demonstrates superior efficiency in breaking down urinary stones compared to the Holmium:YAG (Ho:YAG) laser. Er:YAG achieved greater ablation volumes and deeper craters, indicating its potential as a more effective lithotripsy device.
Area of Science:
- Urology
- Laser Physics
- Biomedical Engineering
Background:
- Urinary calculi (stones) pose a significant clinical challenge.
- Laser lithotripsy is a common treatment modality for stone removal.
Purpose of the Study:
- To compare the lithotripsy efficiency of Erbium:YAG (Er:YAG) and Holmium:YAG (Ho:YAG) lasers.
- To determine if Er:YAG is a more effective device for breaking urinary stones.
Main Methods:
- Ho:YAG and Er:YAG lasers were used to ablate human urinary calculi of known compositions (COM, cystine, UA).
- Laser energy settings ranged from damage threshold to Ho:YAG clinical levels.
- Optical coherence tomography (OCT) measured crater dimensions and ablation volumes.
Main Results:
- Er:YAG consistently produced deeper craters and larger ablation volumes across all stone types and energy levels.
- Ho:YAG generated wider, albeit irregular, craters, particularly with multiple pulses.
Conclusions:
- Er:YAG laser lithotripsy is more efficient than Ho:YAG.
- Higher energy absorption at the Er:YAG wavelength contributes to its superior performance in creating deeper craters.
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