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Fragmentation process of current laser lithotriptors

K Rink1, G Delacrétaz, R P Salathé

  • 1Laboratoire d'Optique Appliquée, Ecole Polytechnique Fédérale de Lausanne, Switzerland.

Lasers in Surgery and Medicine
|January 1, 1995
PubMed
Summary
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Laser lithotripter pulse duration significantly impacts stone fragmentation. Microsecond pulses, utilizing cavitation, offer higher efficiency than nanosecond pulses, which rely on plasma shock waves.

Area of Science:

  • Biomedical Engineering
  • Laser Physics
  • Nephrology

Background:

  • Clinically used laser lithotriptors include flashlamp pumped dye (FPDL), Q-switched Nd:YAG, and alexandrite lasers.
  • These lasers fragment calculi via mechanical stresses, but fragment sizes and efficiencies vary.

Purpose of the Study:

  • To investigate the effect of pulse duration and pulse shape on laser lithotripsy fragmentation processes.
  • To elucidate the physical mechanisms behind differing fragmentation efficiencies of clinical laser lithotriptors.

Main Methods:

  • Fragmentation was characterized using model stones and sensing target fibers.
  • Stone fragmentation and cavitation bubble dynamics were observed using video flash photography.
  • Shock wave generation and intensity were monitored with a hydrophone.

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Main Results:

  • FPDL fragmentation resulted from cavitation bubble collapse.
  • Q-switched Nd:YAG showed fragmentation at plasma onset and bubble collapse.
  • Alexandrite laser pulse durations exhibited an intermediate fragmentation regime.

Conclusions:

  • Nanosecond laser pulses fragment stones via plasma-induced shock waves.
  • Microsecond laser pulses fragment stones via cavitation, demonstrating higher efficiency due to superior energy transfer.
  • This study provides the physical basis for observed differences in laser lithotripter fragmentation efficiencies.