V6-14: Strippers, Scissors and Laser Fiber Tips

V6-14: Strippers, Scissors and Laser Fiber Tips

Video

Introductions and Objectives
Preparation of the laser-fiber tip before initiating laser-lithotripsy procedures is current practice, especially if reusable laser fibers are used. The authors evaluated if this preparation with special tools such as laser-fiber strippers and ceramic scissors or simple metal scissors influences lithotripsy performance.

Methods
The authors demonstrate a video of current and widespread laser fiber tip preparation with specialized tools. Afterwards a precise comparison of this traditional and other methods is performed: laser-fiber tips (of 272-µm core laser fibers) were either stripped with laser-fiber strippers or left untouched (coated); these tips were then cleaved with metal or ceramic scissors, regardless of being stripped or not. Laser-lithotripsy experiments were performed using the previously prepared laser fibers, an automated laser fragmentation testing system, soft and hard material artificial stones (plaster of Paris and BegoStone), and employing high-frequency low-pulse energy (HiFr-LoPE; 20Hz x 0.5J) and low-frequency high-pulse energy (LoFr-HiPE; 5Hz x 2.0J) lithotripter settings. Ablation volume was measured and laser-fiber tips were photographed before and after lithotripsy.

Results
Leaving the fiber coated achieved significantly higher ablation volumes, and stripping the fiber reduced always ablation volume (p