1546 EFFECTS OF HOLMIUM:YAG LASER ENERGY SETTINGS ON FIBER TIP DEGRADATION (2013)

You have accessJournal of UrologyStone Disease: New Technology1 Apr 20131546 EFFECTS OF HOLMIUM:YAG LASER ENERGY SETTINGS ON FIBER TIP DEGRADATION Zachariah Goldsmith, Samarpit Rai, Andreas Neisius, Gaston Astroza, Nicholas Kuntz, Ramay Youssef, Muhammad Iqbal, Agnes Wang, W. Neal Simmons, Glenn Preminger, and Michael Lipkin Zachariah GoldsmithZachariah Goldsmith DURHAM, NC More articles by this author , Samarpit RaiSamarpit Rai DURHAM, NC More articles by this author , Andreas NeisiusAndreas Neisius DURHAM, NC More articles by this author , Gaston AstrozaGaston Astroza DURHAM, NC More articles by this author , Nicholas KuntzNicholas Kuntz DURHAM, NC More articles by this author , Ramay YoussefRamay Youssef DURHAM, NC More articles by this author , Muhammad IqbalMuhammad Iqbal DURHAM, NC More articles by this author , Agnes WangAgnes Wang DURHAM, NC More articles by this author , W. Neal SimmonsW. Neal Simmons DURHAM, NC More articles by this author , Glenn PremingerGlenn Preminger DURHAM, NC More articles by this author , and Michael LipkinMichael Lipkin DURHAM, NC More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3056AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Tip degradation, or “fiber burnback”, can necessitate intra-operative fiber re-stripping during laser lithotripsy which can prolong operative times. We hypothesized that tip degradation is dependent upon energy source settings, and sought to define optimal laser energy settings to minimize this phenomenon. METHODS A bench-top model was developed in which 200 μM laser fibers were kept in contact with cylindrical 25 mm BegoStone phantoms under constant pressure in a saline bath. Various pulse energy and frequency settings were transmitted from a 100 Watt holmium:YAG unit for a constant total radiant energy of 1 kilojoule (kJ). Tip degradation for each setting was determined by measuring the fiber length before and after laser fragmentation, and compared over 5 trials using ANOVA. RESULTS No tip degradation was observed at the lowest energy setting (0.2 J and 50 Hz). Intermediate energy settings (0.5 J and 20 Hz; 0.6 J and 6 Hz; 0.8 J and 8 Hz) resulted in a small amount of tip degradation. The highest energy setting (1.0 J and 10 Hz) resulted in the highest amount of degradation (3.05 + 1.3 mm), which was significantly greater than the lower settings (P < 0.001). CONCLUSIONS These experiments have defined, for the first time, a range of energy settings at which minimal tip degradation is observed in vitro. The setting of 1.0 J and 10 Hz is associated with significant tip degradation, which may offset fragmentation efficiency observed with this setting. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e634 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Metrics Author Information Zachariah Goldsmith DURHAM, NC More articles by this author Samarpit Rai DURHAM, NC More articles by this author Andreas Neisius DURHAM, NC More articles by this author Gaston Astroza DURHAM, NC More articles by this author Nicholas Kuntz DURHAM, NC More articles by this author Ramay Youssef DURHAM, NC More articles by this author Muhammad Iqbal DURHAM, NC More articles by this author Agnes Wang DURHAM, NC More articles by this author W. Neal Simmons DURHAM, NC More articles by this author Glenn Preminger DURHAM, NC More articles by this author Michael Lipkin DURHAM, NC More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...