V6-14: Strippers, Scissors and Laser Fiber Tips
VideoIntroductions 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.
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.
Leaving the fiber coated achieved significantly higher ablation volumes, and stripping the fiber reduced always ablation volume (p
Coated laser-fiber tips ensure a better lithotripsy performance. Metal scissors are as good as expensive ceramic ones as long as the more effective coated fibers are used. This evidence may simplify, enhance and change how laser lithotripsy procedures are performed worldwide.