PD42-06 BALL TIPPED HOLMIUM:YAG OPTICAL FIBERS FOR FLEXIBLE URETEROSCOPY: IS THERE A DIFFERENCE?

Abstract

INTRODUCTION AND OBJECTIVES: Ball tipped laser fibers have been introduced for laser lithotripsy with the intent to allow passage of the fiber through a deflected ureteroscope, without causing trauma to the working channel. We objectively compare a series of commercially available and prototype ball tipped fibers in order to characterize differences in performance characteristics and to compare them to a non-ball tipped variant (Flexiva 200, Boston Scientific). METHODS: A series of experiments were performed to evaluate (i) the insertion force needed to pass the fiber through a ureteroscope deflected to 240 degrees, (ii) the true diameter, (iii) the flexibility (max deflection in Stryker U-500), (iv) energy transmission pre and post testing, and (iv) the resistance to fracture with energy transmission during deflection. RESULTS: Results are summarized in Table 1. CONCLUSIONS: The Med Fibers Dome Tip had the lowest energy transmission. The Flexiva and Flexiva TracTip were the most resistant to fracture with energy transmission during deflection. Three of the four ball-tipped laser fibers required less force than the non-ball tipped fiber for insertion through a maximally deflected ureteroscope (p < 0.05). The Flexiva TracTip allows more facile insertion compared to other ball tipped fibers (p < 0.05) and performs on par or better than the Flexiva 200.