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Intracorporeal lithotripsy with the Alexandrite laser
J D Denstedt1, S S Chun, M D Miller
1Division of Urology, University of Western Ontario, London, Canada.
Lasers in Surgery and Medicine
|January 1, 1997
Summary
The Alexandrite laser showed a 50% fragmentation rate for urinary stones, with frequent equipment failures. Researchers do not recommend this laser lithotripter in its current form.
Area of Science:
- Urology
- Laser Technology
- Medical Devices
Background:
- Intracorporeal lithotripsy is a common procedure for urinary stone removal.
- Various laser systems are used for stone fragmentation.
Purpose of the Study:
- To assess the clinical efficacy of an Alexandrite laser lithotripter for breaking down urinary calculi.
- To evaluate its performance during ureteroscopy and percutaneous nephrolithotripsy procedures.
Main Methods:
- Prospective evaluation of a Q-switched Alexandrite solid-state laser (755 nm wavelength).
- Used in 32 cases involving ureteroscopy (30) and percutaneous nephrolithotripsy (2).
- Pulsed mode with 150-800 ns duration and 30-80 mJ energy settings.
Main Results:
- Achieved a 50% fragmentation rate (16/32 cases).
- Equipment malfunction or technical issues caused failure in 11 cases; inability to fragment stones in 5 cases.
- All failures were successfully managed with alternative treatments. One ureteral perforation occurred, with no long-term sequelae.
Conclusions:
- Alexandrite laser lithotripsy results appear inferior to other laser systems and lithotripsy methods.
- The device is not recommended for urinary stone lithotripsy in its present configuration.
- Future modifications might improve performance, but current limitations are significant.