Abstract

.Significance: Water is a primary absorber of infrared (IR) laser energy, and urinary stones are immersed in fluid in the urinary tract and irrigated with saline during IR laser lithotripsy. Laser-induced vapor bubbles, formed during lithotripsy, contribute to the stone ablation mechanism and stone retropulsion effects.Aim: Introduction of a surfactant may enable manipulation of vapor bubble dimensions and duration, potentially for more efficient laser lithotripsy.Approach: A surfactant with concentrations of 0%, 5%, and 10% was tested. A single pulse from a thulium fiber laser with wavelength of 1940 nm was delivered to the surfactant through a -core optical fiber, using a wide range of laser parameters, including energies of 0.05 to 0.5 J and pulse durations of 250 to .Results: Bubble length, width, and duration with surfactant increased on average by 29%, 17%, and 120%, compared with water only.Conclusions: Our study demonstrated successful manipulation of laser-induced vapor bubble dimensions and duration using a biocompatible and commercially available surfactant. With further study, use of a surfactant may potentially improve the “popcorn” technique of laser lithotripsy within the confined space of the kidney, enable non-contact laser lithotripsy at longer working distances, and provide more efficient laser lithotripsy.

Highlights

  • Urinary stone disease affects about 10% of Americans.[1]

  • Our study demonstrated successful manipulation of laser-induced vapor bubble dimensions and duration using a biocompatible and commercially available surfactant

  • The ureteroscope is introduced into the urinary tract, and a flexible silica optical fiber is inserted through the working channel of the ureteroscope and placed in contact or in close proximity to the stone

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Summary

Introduction

Urinary stone disease affects about 10% of Americans.[1]. A successful minimally invasive method for treatment of small- to moderate-sized (

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