Skip to main content

Advertisement

SpringerLink
Log in

Superpulse thulium fiber laser lithotripsy: an in vitro comparison of 200 μm and 150 μm laser fibers

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Availability of data and material

On demand.

Code availability

On demand.

References

  1. Scott NJ, Cilip CM, Fried NM (2009) Thulium fiber laser ablation of urinary stones through small-core optical fibers. IEEE J Sel Top Quantum Electron 15(2):443–440

    Article  Google Scholar 

  2. Blackmon RL, Hutchens TC, Hardy LA, Wilson CR, Irby PB, Fried NM (2014) Thulium fiber laser ablation of kidney stones using a 50-μm-core silica optical fiber. Opt Eng 54(1):011004

    Article  Google Scholar 

  3. Traxer O, Keller EX (2020) Thulium fiber laser: the new player for kidney stone treatment? A comparison with Holmium:YAG laser. World J Urol 38(8):1883–1894

    Article  CAS  Google Scholar 

  4. Wilson CR, Kennedy JDD, Irby PB, Fried NM (2018) Miniature ureteroscope distal tip designs for potential use in thulium fiber laser lithotripsy. J Biomed Opt 23(7):076003

    Google Scholar 

  5. Andreeva V, Vinarov A, Yaroslavsky I, Kovalenko A, Vybornov A, Rapoport L et al (2020) Preclinical comparison of superpulse thulium fiber laser and a holmium:YAG laser for lithotripsy. World J Urol 38(2):497–503

    Article  CAS  Google Scholar 

  6. Taratkin M, Laukhtina E, Singla N, Kozlov V, Abdusalamov A, Ali S et al (2020) Temperature changes during laser lithotripsy with Ho:YAG laser and novel Tm-fiber laser: a comparative in-vitro study. World J Urol 38(12):3261–3266. https://doi.org/10.1007/s00345-020-03122-1

    Article  CAS  PubMed  Google Scholar 

  7. Hein S, Petzold R, Schoenthaler M, Wetterauer U, Miernik A (2018) Thermal effects of Ho: YAG laser lithotripsy: real-time evaluation in an in vitro model. World J Urol 36(9):1469–1475

    Article  CAS  Google Scholar 

  8. Wollin DA, Carlos EC, Tom WR, Simmons WN, Preminger GM, Lipkin ME (2018) Effect of laser settings and irrigation rates on ureteral temperature during holmium laser lithotripsy, an in vitro model. J Endourol 32:59–63

    Article  Google Scholar 

  9. Peplinski B, Faaborg D, Miao E, Alsyouf M, Myklak K, Kelln W et al (2016) The effect of laser fiber cleave technique and lithotripsy time on power output. J Endourol 30(6):678–684

    Article  Google Scholar 

  10. Panthier F, Doizi S, Lapouge P, Chaussain C, Kogane N, Berthe L et al (2020) Comparison of the ablation rates, fissures and fragments produced with 150 µm and 272 µm laser fibers with superpulsed thulium fiber laser: an in vitro study. World J Urol 39(6):1683–1691

    Article  Google Scholar 

  11. Taratkin M, Laukhtina E, Singla N, Tarasov A, Alekseeva T, Enikeev M et al (2020) How Lasers Ablate Stones: In Vitro Study of Laser Lithotripsy (Ho:YAG and Tm-Fiber Lasers) in Different Environments. J Endourol 35(6):931–936

    Article  Google Scholar 

  12. Marguet CG, Sung JC, Springhart WP, L’Esperance JO, Zhou S, Zhong P et al (2005) In vitro comparison of stone retropulsion and fragmentation of the frequency doubled, double pulse Nd:YAG laser and the holmium:YAG laser. J Urol 173(5):1797–1800

    Article  Google Scholar 

  13. White MD, Moran ME, Calvano CJ, Borhan-Manesh A, Mehlhaff BA (1998) Evaluation of retropulsion caused by holmium:YAG laser with various power settings and fibers. J Endourol 12(2):183–186

    Article  CAS  Google Scholar 

  14. Lee H, Ryan RT, Teichman JMH, Kim J, Choi B, Arakeri NV et al (2003) Stone retropulsion during holmium:YAG lithotripsy. J Urol 169(3):881–885

    Article  Google Scholar 

  15. Bader MJ, Pongratz T, Khoder W, Stief CG, Herrmann T, Nagele U et al (2015) Impact of pulse duration on Ho:YAG laser lithotripsy: fragmentation and dusting performance. World J Urol 33(4):471–477

    Article  Google Scholar 

  16. Enikeev D, Shariat SF, Taratkin M, Glybochko P (2020) The changing role of lasers in urologic surgery. Curr Opin Urol 30(1):24–29

    Article  Google Scholar 

  17. Blackmon RL, Irby PB, Fried NM (2011) Comparison of holmium:YAG and thulium fiber laser lithotripsy: ablation thresholds, ablation rates, and retropulsion effects. J Biomed Opt 16(7):071403

    Article  Google Scholar 

  18. Hardy LA, Wilson CR, Irby PB, Fried NM (2014) Thulium fiber laser lithotripsy in an in vitro ureter model. J Biomed Opt 19(12):128001

    Article  Google Scholar 

  19. Mues AC, Teichman JMH, Knudsen BE (2009) Quantification of holmium: yttrium aluminum garnet optical tip degradation. J Endourol 23(9):1425–1428

    Article  Google Scholar 

  20. Khemees TA, Shore DM, Antiporda M, Teichman JMH, Knudsen BE (2013) Evaluation of a new 240-μm single-use holmium:YAG optical fiber for flexible ureteroscopy. J Endourol 27(4):475–479

    Article  Google Scholar 

  21. Hutchens TC, Blackmon RL, Irby PB, Fried NM (2013) Hollow steel tips for reducing distal fiber burn-back during thulium fiber laser lithotripsy. J Biomed Opt 18(7):078001

    Article  Google Scholar 

  22. Enikeev D, National Library of Medicine (U.S.) (2020) Comparison of SP TFL and Ho:YAG for RIRS using 145 µm and 200 µm fibers. Identifier NCT04346485. Available from: https://clinicaltrials.gov/ct2/show/NCT04346485https://clinicaltrials.gov/ct2/show/NCT04346485

  23. Fried NM (2018) Recent advances in infrared laser lithotripsy [invited]. Biomed Opt Express 9(9):4552

    Article  CAS  Google Scholar 

Download references

Acknowledgements

To NTO-IRE Polus/IPG Photonics for providing equipment and to Viktoriya Andreeva and Ilya Yaroslavsky for discussing results.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St., Moscow, 119991, Russia

    Mark Taratkin, Sergey Allenov, Jasur Inoyatov, Stanislav Ali & Dmitry Enikeev

  2. International School “Medicine of the Future”, Sechenov University, Moscow, Russia

    Camilla Azilgareeva

  3. GRC #20 Lithiase Urinaire, Sorbonne University, Hôpital Tenon, Paris, France

    Mariela Corrales

  4. Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China

    Jeremy Yuen-Chun Teoh

  5. Department of Urology, Clinico San Carlos University Hospital, Madrid, Spain

    Juan Gomez Rivas

  6. Institute of Linguistics and Intercultural Communication, Sechenov University, Moscow, Russia

    Irina Markovina

Authors
  1. Mark Taratkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Camilla Azilgareeva
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mariela Corrales
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jeremy Yuen-Chun Teoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sergey Allenov
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jasur Inoyatov
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Stanislav Ali
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Juan Gomez Rivas
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Irina Markovina
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Dmitry Enikeev
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MT: Project development, Data collection, Manuscript writing. CA: Data analysis, Manuscript writing. MC: Manuscript editing. JYCT: Manuscript editing. SA: Project development, Data analysis. JI: Project development, Data analysis. SA: Project development, Data collection. JGR: Manuscript editing. IM: Project development, Manuscript editing. DE: Project development, Manuscript editing.

Corresponding author

Correspondence to Dmitry Enikeev.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest.

Research involving human participants and/or animals

N/A.

Informed consent

N/A.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary Figure 1

Setup for stone ablation assessment. Supplementary file 1 (PNG 849 KB)

Supplementary Figure 2

Setup for retropulsion assessment. Supplementary file 2 (PNG 2203 KB)

Supplementary Figure 3

Setup for temperature assessment Supplementary file 3 (PNG 1561 KB)

Supplementary Figure 4

Retropulsion curves for two types of laser fibers. Supplementary file 4 (PNG 38 KB)

Supplementary Figure 5

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)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-021-03800-8

Keywords

Search

Navigation