Endoscopic applications of the Erbium:YAG laser have been limited due to the lack of a suitable optical fiber
delivery system. This study compares the transmission of Er:YAG laser radiation through germanium oxide trunk
fibers with silica or sapphire fiber tips for potential use in endoscopic tissue ablation. Er:YAG laser radiation with a
wavelength of 2.94 &mgr;m, pulse length of 300 &mgr;s, pulse energies of 5-1360 mJ, and pulse rates of 3-10 Hz, was
delivered through 1-m-long germanium oxide fibers with either 1-cm-long, 550-&mgr;m-diameter silica or sapphire tips.
Transmission through the germanium oxide / sapphire fibers measured 65 + 5 % compared with 55 + 4 % for the
germanium oxide / silica fibers (P < 0.05). The damage threshold for the hybrid fibers averaged 309 + 44 mJ and
126 + 43 mJ, respectively (n = 7 fibers each) (P < 0.05). Maximum pulse energies transmitted through the fibers
were 700 mJ and 220 mJ, respectively. Improved index-matching of the trunk fiber and fiber tip at 2.94 &mgr;m resulted
in higher transmission and damage thresholds for the germanium oxide / sapphire fibers. The germanium oxide /
sapphire fiber may represent a promising mid-IR optical fiber delivery system for use in endoscopic applications of
the Er:YAG laser requiring a flexible, biocompatible, and robust fiber delivery system for contact tissue ablation.