The study of Ho: YAG laser ablation thresholds of calculus phantom in terms of peak power density (Conference Presentation)

Abstract

Laser lithotripsy is now the preferred treatment option for urolithiasis over Shock wave lithotripsy (SWL) for renal stones smaller than 1.5 cm due to shorter operation times and a better stone-free rates (from the retrospective study by E. B. Cone et al). Nonetheless, the detailed mechanism of calculus disintegration by laser pulse remains relatively unclear. One of the fundamental parameters for laser stone interaction is the ablation threshold. Richard L. Blackmon, et. al. have studied the ablation threshold for Ho: YAG and the thulium fiber lasers (TFL) in terms of the laser energy density. However, an ablation threshold in terms of peak power density would be more universally applicable. In this study, two commercially available Ho: YAG lasers were used as the laser pulse source. The fibers used in the investigation are SureFlexTM fibers, (Models S-LLF273 and S-LLF365) with 273 and 365 μm core diameters, respectively. Calculus phantoms were made of the Bego stone material with various degrees of hardness. These stone phantoms were ablated with the Ho: YAG lasers at different peak power densities. The laser pulse width was measured utilizing a 2 μm photodiode (Thorlabs DET10D), and the laser-induced crater volumes were evaluated with a 3-D digital microscope (Keyence VHX-900F). In this way, we determined the ablation threshold as a function of peak power density for the Bego stone phantoms with 3 different hardness values. Additional investigations of the ablation threshold of other stone types will be conducted in a future study.