Presentation Authors: Bodo Knudsen*, Columbus, OH, Ben Chew, Vancouver, Canada, Wilson Molina, Kansas City, KS
Introduction: Thulium fiber laser technology is an emerging field for laser lithotripsy that addresses inherent limitations of the Holmium:YAG laser including high current requirements, limited pulse frequency, and poor coupling with sub-200 Âµm core sized fibers. The Super Pulse Thulium fiber (SPTF) laser system was compared to a 120W Holmium:YAG system with respect to retropulsion and laser fiber burn back.
Methods: A force sensor was used to measure retropulsion when laser energy was applied to a Begostone phantom. Both fragmentation and dusting settings were measured (n=15). The retropulsion force was recorded both per pulse and per second at each setting. Laser fiber burn back was measured with the Begostone phantom in contact with the laser fiber tip. Two hundred micron fibers were utilized for the testing.
Results: The SPTF laser produced significantly less retropulsion compared to long pulse dusting and fragmentation settings of the 120W Holmium:YAG laser (p < 0.001). Retropulsion of the Thulium fiber laser was similar when compared to the Holmium:YAG laser in Moses mode (Figs 1 & 2). Laser fiber burnback was significantly less for the SPTF laser as compared to the Ho:YAG laser at all settings tested. (p < 0.001, Fig 3).
Conclusions: The SPTF laser created less retropulsion in comparison to the Holmium:YAG laser at all tested settings with the exception of Moses mode, which was equivalent. The Thulium fiber system had diminished fiber burnback in comparison the 120w Holmium:YAG system.
Source of Funding: Olympus America