To investigate the thermal effects, stone retropulsion and ablation rate of SuperPulse Thulium-fiber laser (SP TFL) with two different surgical fibers of 200 and 150 μm in diameter.
SP TFL (NTO IRE-Polus, Fryazino, Russia) performance with 200 and 150 μm fibers (NTO IRE-Polus, Fryazino, Russia) was evaluated. Before each test, the laser fiber was cleaved, and the power measurement was taken to verify the actual laser output power. To compare the laser fibers in well-controlled environments, a number of setups were used to assess retropulsion, ablation efficacy, fiber burnback, energy transmission, and safety.
Power measurements performed before each test revealed a 4.7% power drop for a 200 μm fiber SP TFL (14.3 ± 0.5 W) and 7.3% power drop for a 150 μm fiber SP TFL (13.9 ± 0.5 W) versus the nominally indicated power (15.0 W). Retropulsion with the TFL was minimal and comparable between fibers. We found no clinically relevant temperature differences between SP TFL with either 200 or 150 μm fibers. The ablation efficacy tended to be comparable under most parameters. Yet, we did observe a decreased diameter of residual fragments after the ablation with a 150 μm fiber.
The smaller fiber (150 μm) is not inferior to 200 μm fiber in terms of fiber burnback, retropulsion, safety, and ablation rate. Moreover, it has the potential to decrease the diameter of fragments during lithotripsy, which may facilitate dusting during RIRS.
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To NTO-IRE Polus/IPG Photonics for providing equipment and to Viktoriya Andreeva and Ilya Yaroslavsky for discussing results.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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The authors declare that there is no conflict of interest.
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Below is the link to the electronic supplementary material.
Setup for stone ablation assessment. Supplementary file 1 (PNG 849 KB)
Setup for retropulsion assessment. Supplementary file 2 (PNG 2203 KB)
Setup for temperature assessment Supplementary file 3 (PNG 1561 KB)
Retropulsion curves for two types of laser fibers. Supplementary file 4 (PNG 38 KB)
Flexible ureteroscope with 200 and 150 mcm fibers at maximal curvature. No changes in curvature depending on fiber are observed. Supplementary file 5 (PNG 336 KB)
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Taratkin, M., Azilgareeva, C., Corrales, M. et al. Superpulse thulium fiber laser lithotripsy: an in vitro comparison of 200 μm and 150 μm laser fibers. World J Urol 39, 4459–4464 (2021). https://doi.org/10.1007/s00345-021-03800-8
- In vitro
- Kidney stones
- Thermal effects
- Thulium fiber laser