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Optical Feedback for Safe Automatic Laser Lithotripsy: Tissue Sensor Implementation in a Clinical System.

Nadezhda Korneva1,2, Gleb Budylin3, Polina Tseregorodtseva1

  • 1Faculty of Physics, Lomonosov Moscow State University, Moscow, Russia.

Lasers in Surgery and Medicine
|December 16, 2025
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Summary
This summary is machine-generated.

This study introduces an optical feedback system for laser lithotripsy that distinguishes urinary stones from soft tissues. The system enhances procedural safety by minimizing unintended laser exposure to non-target tissues.

Keywords:
diffuse reflectance spectroscopylaser lithotripsyreal‐time tissue differentiation

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Area of Science:

  • Urology
  • Optical Engineering
  • Medical Devices

Background:

  • Laser lithotripsy is a common procedure for urinary stone removal.
  • Accidental damage to surrounding soft tissues is a potential risk during laser lithotripsy.
  • Current methods lack real-time differentiation between stones and tissues.

Purpose of the Study:

  • To develop an optical feedback system for real-time differentiation between urinary stones and soft tissues.
  • To enhance the safety and precision of laser lithotripsy procedures.
  • To integrate the system with commercial surgical lasers.

Main Methods:

  • Diffuse reflectance spectroscopy (DRS) was employed in a clinical theranostic platform.
  • In vivo experiments collected and analyzed DRS spectra of tissues during laser lithotripsy.
  • Machine learning algorithms, including Principal Component Analysis (PCA) and Linear Discriminant Analysis (LDA), were used for classification.

Main Results:

  • The system achieved 93% sensitivity for soft tissue identification and 93% specificity for stone detection using LDA.
  • Real-time differentiation effectively minimized unintended laser exposure to non-target tissues.
  • High diagnostic performance was demonstrated in distinguishing stones from soft tissues.

Conclusions:

  • The developed optical guidance system offers real-time feedback during laser lithotripsy.
  • It significantly improves procedural safety by reducing the risk of accidental tissue damage.
  • This technology is expected to enhance outcomes in minimally invasive urological laser procedures.