6 February 2017 Miniature ureteroscope tip designs for use in thulium fiber laser lithotripsy
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Abstract
A miniature ureteroscope has the potential to eliminate need for full anesthesia and dilation, increase comfort and safety of laser lithotripsy via ureteroscopy, and reduce hospital costs via an office based procedure. A prototype, 4.5 Fr (1.5-mm-OD), five channel ureteroscope tip was developed, housing a 200-μm-ID central channel for insertion of small, 100-μm-core fibers and four surrounding channels, each with 510-μm-ID for instrumentation, irrigation, imaging, and illumination, respectively. Common urological instruments (including fibers, guidewires, and stone baskets) were inserted through tip’s working channels to demonstrate feasibility. Low irrigation rates were measured, revealing a need for manual pump-assisted irrigation. Imaging was conducted using 3k, 6k, and 10k pixel miniature flexible endoscopes with 0.4, 0.6, and 0.9 mm outer diameters, respectively. The 3k pixel endoscope with integrated illumination was inserted through the prototype unimpeded, and successfully demonstrated ability to differentiate between hard tissues (e.g. kidney stones) and soft tissues (e.g. ureter wall), for visibility and safety during potential clinical application. Based on both image quality and instrument diameter, the 6k pixel endoscope provided an optimal solution for miniature ureteroscopy.
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Joshua D. Kennedy, Joshua D. Kennedy, Christopher R. Wilson, Christopher R. Wilson, Pierce B. Irby, Pierce B. Irby, Nathaniel M. Fried, Nathaniel M. Fried, } "Miniature ureteroscope tip designs for use in thulium fiber laser lithotripsy", Proc. SPIE 10038, Therapeutics and Diagnostics in Urology: Lasers, Robotics, Minimally Invasive, and Advanced Biomedical Devices, 100380Q (6 February 2017); doi: 10.1117/12.2247822; https://doi.org/10.1117/12.2247822
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