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Variable Pulse Duration From a New Holmium:YAG Laser: The Effect on Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model.

Publication ,  Journal Article
Wollin, DA; Ackerman, A; Yang, C; Chen, T; Simmons, WN; Preminger, GM; Lipkin, ME
Published in: Urology
May 2017

OBJECTIVE: To more clearly define the efficiency and potential benefits of variable pulse-width laser technology for ureteroscopic lithotripsy, we performed comparative in vitro evaluations assessing stone comminution, laser fiber tip degradation, and stone retropulsion. METHODS: All experiments were conducted using a Swiss LaserClast Holmium:YAG laser (Electro Medical Systems, Nyon, Switzerland) with adjustable pulse duration (300 µs-1500 µs). To assess comminution efficiency and fiber tip degradation, a "dusting" model was employed; the laser fiber tip was moved by a 3-dimensional positioning system in a spiral motion across a flat BegoStone surface submerged in water. Comminution efficiency was measured as the loss of stone mass while fiber tip degradation was measured simultaneously. The same laser and fiber were used in a pendulum model to measure stone retropulsion with a high-speed resolution camera. RESULTS: In our dusting model, comminution was significantly greater at high energy (2 J/5 Hz). At the high energy setting, comminution was significantly greater with long pulse duration than short pulse, although this difference was not seen at the high frequency setting (1 J/10 Hz). Tip degradation was increased at high energy settings and was even more pronounced with short pulse duration than long pulse. Short pulse duration caused far more retropulsion than the long pulse setting. CONCLUSION: In an in vitro dusting model, a longer laser pulse duration provides effective stone comminution with the advantage of reducing laser fiber tip degradation and stone retropulsion.

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Published In

Urology

DOI

EISSN

1527-9995

Publication Date

May 2017

Volume

103

Start / End Page

47 / 51

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureteral Calculi
  • Treatment Outcome
  • Phantoms, Imaging
  • Lithotripsy, Laser
  • Lasers, Solid-State
  • Humans
  • Holmium
  • Heart Rate
  • Equipment Design
 

Citation

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Wollin, D. A., Ackerman, A., Yang, C., Chen, T., Simmons, W. N., Preminger, G. M., & Lipkin, M. E. (2017). Variable Pulse Duration From a New Holmium:YAG Laser: The Effect on Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model. Urology, 103, 47–51. https://doi.org/10.1016/j.urology.2017.01.007
Wollin, Daniel A., Anika Ackerman, Chen Yang, Tony Chen, Walter Neal Simmons, Glenn M. Preminger, and Michael E. Lipkin. “Variable Pulse Duration From a New Holmium:YAG Laser: The Effect on Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model.Urology 103 (May 2017): 47–51. https://doi.org/10.1016/j.urology.2017.01.007.
Wollin DA, Ackerman A, Yang C, Chen T, Simmons WN, Preminger GM, et al. Variable Pulse Duration From a New Holmium:YAG Laser: The Effect on Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model. Urology. 2017 May;103:47–51.
Wollin, Daniel A., et al. “Variable Pulse Duration From a New Holmium:YAG Laser: The Effect on Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model.Urology, vol. 103, May 2017, pp. 47–51. Pubmed, doi:10.1016/j.urology.2017.01.007.
Wollin DA, Ackerman A, Yang C, Chen T, Simmons WN, Preminger GM, Lipkin ME. Variable Pulse Duration From a New Holmium:YAG Laser: The Effect on Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model. Urology. 2017 May;103:47–51.
Journal cover image

Published In

Urology

DOI

EISSN

1527-9995

Publication Date

May 2017

Volume

103

Start / End Page

47 / 51

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureteral Calculi
  • Treatment Outcome
  • Phantoms, Imaging
  • Lithotripsy, Laser
  • Lasers, Solid-State
  • Humans
  • Holmium
  • Heart Rate
  • Equipment Design