1 June 1990 Comparison of different pulsed and Q-switched solid state laser systems for endoscopic laser-induced shockwave lithotripsy: performance and laser/stone interactions
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Abstract
At present the laser induced shock wave lithotripsy (LISL) of urinary and biliary stones via fiber optic beam delivery is governed by two competing' laser systems: The flashlamp-pumped pulsed dye laser and the Q-switched Nd:YAG laser. The pulsed radiation of the dye system with pulse durations in the 1-2 .tsec region can be easily transmitted through extremely flexible fused silica fibers with core diameters of only 200 im whilst the Q-switched Nd:YAG laser with pulselengths of 5-25 nsec needs fibers with more than 400 tm core diameter. The dye laser releases acoustic shock waves for fragmentation simply by stone contact, the Q-switched Nd:YAG produces these waves in the surrounding aqueous medium by laser induced optical breakdown (LIB) when refocused by optical means or through additional metal absorbers, i.e. opto - mechanical couplers. We report on the system performances and laser/stone interactions of two alternative solid-state laser systems with variable pulselengths in the range of 1.7 - 30 sec and 30 - 1000 nsec, respectively: The pulsed psec-Nd:YAG laser and the Q-switched alexandrite laser. Regarding the endoscopic laser lithotripsy of urinary and biliary stones in the ureter or common bile duct, respectively, the laser energy delivery system, i.e. the optical fiber; is the most stressed part. Therefore we used long-pulse solid-state laser systems like the pulsed Nd:YAG laser with a pulse-slicing unit and a pulselength-tunable Q-switched alexandrite laser and studied fragmentation of synthetic plaster samples as well as urinary and biliary stones. The radiation of both laser systems can be effectively transmitted via standard 200 im core diameter optical quartz fibers what is absolutely necessary when used in conjunction with small caliber rigid or flexible endoscopes. As a compact and reliable solid-state system the alexandrite laser lithotripter is much less expensive than an extracorporeal shock wave lithotripter with the same fragmentation results and may become the laser of choice for LISL.
© (1990) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.
Erwin Steiger, "Comparison of different pulsed and Q-switched solid state laser systems for endoscopic laser-induced shockwave lithotripsy: performance and laser/stone interactions", Proc. SPIE 1200, Laser Surgery: Advanced Characterization, Therapeutics, and Systems II, (1 June 1990); doi: 10.1117/12.17445; https://doi.org/10.1117/12.17445
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