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

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.

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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

Affiliations

Authors

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.

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Supplementary Information

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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)

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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

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Keywords

  • In vitro
  • Kidney stones
  • Thermal effects
  • Thulium fiber laser
  • Retropulsion