Abstract
Purpose
Holmium:YAG laser is the most used laser for urolithiasis. Generally, we use metallic scissors to cut the fiber tip to restore its effectiveness. Many cleaving methods have been described to avoid fiber damage and to restore its greatest power to the fiber. There is a lack of information regarding which cleaving method should be used and its effect on the fiber. In order to compare these effects, we studied different cleavage methods in terms of power output and its effects on the fiber.
Methods
New single-use 272-μm fibers were used with a holmium:YAG laser lithotripter. Five kinds of fiber tips were compared: a new intact fiber, cleaved with ceramic scissors, cleaved with metallic scissors, first cleaved then stripped and first stripped then cleaved. The fibers were used against synthetic stones (BegoStone®) similar to calcium oxalate monohydrate, with fragmentation (SP, 5 Hz, 1.5 J) and dusting (LP, 15 Hz, 0.5 J) settings. We measured power output at 0, 1, 5, 10 and 15 min.
Results
For fragmentation parameters, there was a statistical difference between the 5 groups at 0 and 1 min of laser use (p < 0.05) and none for time period over 1 min (p = 0.077–0.658). For dusting parameters, there was a statistical difference between the 5 groups at 0 min of laser use (p < 0.05) and none for time period over 0 min (p = 0.064–1).
Conclusion
Cleaving the fiber tip may restore its effectiveness to the fiber, but only for a limited time, although it may preserve the scopes from damage.
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Acknowledgements
Mattieu Haddad is supported by the AFU scholarship from the French Association of Urology. Esteban Emiliani is supported by the EUSP scholarship program from the European Association of Urology.
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Protocol/project development was by M. Haddad and O. Traxer. Data collection or management was by M. Haddad Y. Rouchausse, F. Coste and L. Berthe. Data analysis was done by M. Haddad and S. Buttice. Manuscript writing/editing was by M. Haddad, E. Emiliani, S. Doizi and B. Somani.
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Prof. O. Traxer is a consultant for Olympus, Rocamed, Coloplast and Boston Scientific. The rest of the authors declare that they do not have conflicts of interest.
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Haddad, M., Emiliani, E., Rouchausse, Y. et al. Impact of laser fiber tip cleavage on power output for ureteroscopy and stone treatment. World J Urol 35, 1765–1770 (2017). https://doi.org/10.1007/s00345-017-2053-1
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DOI: https://doi.org/10.1007/s00345-017-2053-1