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

Article dans une revue avec comité de lecture
Author
HADDAD, Mattieu
86289 Laboratoire Procédés et Ingénierie en Mécanique et Matériaux [PIMM]
EMILIANI, Esteban
98227 Universitat Autònoma de Barcelona = Autonomous University of Barcelona = Universidad Autónoma de Barcelona [UAB]
ROUCHAUSSE, Yann
86289 Laboratoire Procédés et Ingénierie en Mécanique et Matériaux [PIMM]
COSTE, Frédéric
86289 Laboratoire Procédés et Ingénierie en Mécanique et Matériaux [PIMM]
BERTHE, Laurent
86289 Laboratoire Procédés et Ingénierie en Mécanique et Matériaux [PIMM]
DOIZI, Steeve
541997 Sorbonne Université - Faculté de Médecine [SU FM]
BUTTICÈ, Salvatore
SOMANI, Bhaskar Kumar
TRAXER, Olivier P.

URI
http://hdl.handle.net/10985/15520
DOI
10.1007/s00345-017-2053-1
Date
2017
Journal
World Journal of Urology

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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