This study characterizes laser-induced vapor bubbles for five distal fiber optic tip configurations, to provide insight into stone retropulsion experienced during laser ablation of kidney stones. A TFL with 1908-nm wavelength delivered 34 mJ energy per pulse at 500-μs pulse duration through five different fibers: 100-μm-core/170-μm-OD bare fiber tip, 150-μm- to 300-μm-core tapered fiber tip, 100-μm-core/300-μm-OD ball tip fiber, 100-μm-core/340- μm-OD hollow steel tip fiber, and 100-μm-core/560-μm-OD muzzle brake fiber tip. A high speed camera with 10- μm spatial and 9.5-μs temporal resolution imaged vapor bubble dynamics. A needle hydrophone measured pressure transients in forward (0°) and side (90°) directions while placed at a 6.8 ± 0.4 mm distance from fiber tip. Maximum bubble dimensions (width/length) averaged 0.7/1.5, 1.0/1.6, 0.5/1.1, 0.8/1.9, and 0.7/1.5 mm, for bare, tapered, ball, hollow steel, and muzzle tips, respectively (n=5). The hollow steel tip exhibited the most elongated vapor bubble shape, translating into increased forward pressure in this study and consistent with higher stone retropulsion in previous reports. Relative pressures (a.u.) in (forward/side) directions averaged 1.7/1.6, 2.0/2.0, 1.4/1.2, 6.8/1.1, and 0.3/1.2, for each fiber tip (n=5). For hollow steel tip, forward pressure was 4× higher than for bare fiber. For the muzzle brake fiber tip, forward pressure was 5× lower than for bare fiber. Bubble dimensions and pressure measurements demonstrated that the muzzle tip reduced forward pressure by partially venting vapors through side holes, consistent with lower stone retropulsion observed in previous reports.
David A. Gonzalez, Luke A. Hardy, Thomas C. Hutchens, Pierce B. Irby, and Nathaniel M. Fried, "Thulium fiber laser induced vapor bubbles using bare, tapered, ball, hollow steel, and muzzle brake fiber optic tips," Proc. SPIE 10468, Therapeutics and Diagnostics in Urology 2018, 1046806 (Presented at SPIE BiOS: January 27, 2018; Published: 7 February 2018); https://doi.org/10.1117/12.2285076.
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