Lithotripsy Performance of Specially Designed Laser Fiber Tips

Area of Science:

• Urology
• Medical Devices
• Laser Technology

Background:

• Laser lithotripsy is a common procedure for kidney stone removal.
• Fiber optic technology is crucial for delivering laser energy during lithotripsy.
• Novel fiber designs aim to improve stone fragmentation efficiency and fiber durability.

Purpose of the Study:

• To compare the lithotripsy performance of a standard laser fiber with specialized fibers featuring enhanced tip designs.
• To evaluate the durability and effectiveness of different laser fiber tips under various lithotripsy settings.

Main Methods:

• A standard 272 μm core fiber was compared to a 240 μm polished tip fiber and a 240 μm ball-shaped tip fiber.
• An automated system performed 30-second laser lithotripsy experiments using soft and hard stones.
• Experiments utilized two settings: high frequency/low pulse energy (20 Hz, 0.5 J) and low frequency/high pulse energy (5 Hz, 2.0 J).
• Ablation volume and fiber tip condition were assessed post-experiment.

Main Results:

• Standard and ball-shaped tip fibers showed comparable ablation volumes, significantly outperforming the polished tip fiber.
• The ball-shaped tip fiber exhibited significant degradation after use at high pulse energy settings.
• Initial use of high pulse energy settings reduced subsequent ablation volume by over 20% for polished and ball-shaped tips.

Conclusions:

• Standard laser fibers are effective and can be superior to specially designed lithotripsy fibers.
• The rapid degradation of specialized fiber tips limits their widespread clinical application.
• Ball-shaped tip fibers may offer benefits in specific, limited lithotripsy scenarios.