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Impact of laser fiber tip cleavage on power output for ureteroscopy and stone treatment

Impact of laser fiber tip cleavage on power output for ureteroscopy and stone treatment
Impact of laser fiber tip cleavage on power output for ureteroscopy and stone treatment

PURPOSE: Holmium:YAG laser is the most used laser for urolithiasis. Generally, we use metallic scissors to cut the fiber tip to restore its effectiveness. Many cleaving methods have been described to avoid fiber damage and to restore its greatest power to the fiber. There is a lack of information regarding which cleaving method should be used and its effect on the fiber. In order to compare these effects, we studied different cleavage methods in terms of power output and its effects on the fiber.

METHODS: New single-use 272-μm fibers were used with a holmium:YAG laser lithotripter. Five kinds of fiber tips were compared: a new intact fiber, cleaved with ceramic scissors, cleaved with metallic scissors, first cleaved then stripped and first stripped then cleaved. The fibers were used against synthetic stones (BegoStone®) similar to calcium oxalate monohydrate, with fragmentation (SP, 5 Hz, 1.5 J) and dusting (LP, 15 Hz, 0.5 J) settings. We measured power output at 0, 1, 5, 10 and 15 min.

RESULTS: For fragmentation parameters, there was a statistical difference between the 5 groups at 0 and 1 min of laser use (p < 0.05) and none for time period over 1 min (p = 0.077-0.658). For dusting parameters, there was a statistical difference between the 5 groups at 0 min of laser use (p < 0.05) and none for time period over 0 min (p = 0.064-1).

CONCLUSION: Cleaving the fiber tip may restore its effectiveness to the fiber, but only for a limited time, although it may preserve the scopes from damage.

Journal Article
0724-4983
1765-1770
Haddad, M.
509c6b86-c19f-44e9-a562-bbfe9be7c108
Emiliani, E.
aa8ffdc6-c992-48e4-8623-454e015a3812
Rouchausse, Y.
af20d071-ad70-4eb2-9129-f4a82584d12b
Coste, F.
771f14f5-26c5-4dfe-84c9-248a4cf4715f
Berthe, L.
4768fdb0-ceb7-4fc7-b428-bb91ff5e5c9e
Doizi, S.
78d0331b-2eee-459b-97bd-8e728868211e
Buttice, S.
4f3a3ccd-b188-40d4-91a5-586e3b85e3aa
Somani, B.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Traxer, O.
2fa78817-b6f8-4f00-b389-c9c9ddbd01f3
Haddad, M.
509c6b86-c19f-44e9-a562-bbfe9be7c108
Emiliani, E.
aa8ffdc6-c992-48e4-8623-454e015a3812
Rouchausse, Y.
af20d071-ad70-4eb2-9129-f4a82584d12b
Coste, F.
771f14f5-26c5-4dfe-84c9-248a4cf4715f
Berthe, L.
4768fdb0-ceb7-4fc7-b428-bb91ff5e5c9e
Doizi, S.
78d0331b-2eee-459b-97bd-8e728868211e
Buttice, S.
4f3a3ccd-b188-40d4-91a5-586e3b85e3aa
Somani, B.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Traxer, O.
2fa78817-b6f8-4f00-b389-c9c9ddbd01f3

Haddad, M., Emiliani, E., Rouchausse, Y., Coste, F., Berthe, L., Doizi, S., Buttice, S., Somani, B. and Traxer, O. (2017) Impact of laser fiber tip cleavage on power output for ureteroscopy and stone treatment. World Journal of Urology, 35 (11), 1765-1770. (doi:10.1007/s00345-017-2053-1).

Record type: Article

Abstract

PURPOSE: Holmium:YAG laser is the most used laser for urolithiasis. Generally, we use metallic scissors to cut the fiber tip to restore its effectiveness. Many cleaving methods have been described to avoid fiber damage and to restore its greatest power to the fiber. There is a lack of information regarding which cleaving method should be used and its effect on the fiber. In order to compare these effects, we studied different cleavage methods in terms of power output and its effects on the fiber.

METHODS: New single-use 272-μm fibers were used with a holmium:YAG laser lithotripter. Five kinds of fiber tips were compared: a new intact fiber, cleaved with ceramic scissors, cleaved with metallic scissors, first cleaved then stripped and first stripped then cleaved. The fibers were used against synthetic stones (BegoStone®) similar to calcium oxalate monohydrate, with fragmentation (SP, 5 Hz, 1.5 J) and dusting (LP, 15 Hz, 0.5 J) settings. We measured power output at 0, 1, 5, 10 and 15 min.

RESULTS: For fragmentation parameters, there was a statistical difference between the 5 groups at 0 and 1 min of laser use (p < 0.05) and none for time period over 1 min (p = 0.077-0.658). For dusting parameters, there was a statistical difference between the 5 groups at 0 min of laser use (p < 0.05) and none for time period over 0 min (p = 0.064-1).

CONCLUSION: Cleaving the fiber tip may restore its effectiveness to the fiber, but only for a limited time, although it may preserve the scopes from damage.

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Accepted/In Press date: 25 May 2017
e-pub ahead of print date: 30 May 2017
Published date: 1 November 2017
Keywords: Journal Article

Identifiers

Local EPrints ID: 419091
URI: http://eprints.soton.ac.uk/id/eprint/419091
ISSN: 0724-4983
PURE UUID: 3ba37fb7-2089-4503-b42d-7095110518a5

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Date deposited: 29 Mar 2018 16:30
Last modified: 06 Oct 2020 23:55

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Contributors

Author: M. Haddad
Author: E. Emiliani
Author: Y. Rouchausse
Author: F. Coste
Author: L. Berthe
Author: S. Doizi
Author: S. Buttice
Author: B. Somani
Author: O. Traxer

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