Abstract

Laser lithotripsy is the preferred application for the ureteroscopic destruction of ureteral and kidney stones. Clinically fibre assisted Ho:YAG lasers (λ=2.1 µm) are used to induce thermome-chanical ablation. This study focussed on the investigation of different laser parameters in relation to the stone destruction efficiency. Furthermore the fluorescence of human urinary stones was investigated. Experiments were performed using clinical available Ho:YAG laser parameters. The energy was applied onto standardized phantom calculi (Bego-Stones) in an aquarium set-up. Efficient dusting was achieved by using low energy/pulse (approx. 0.5J/pulse) and repetition rate of around 40 Hz. Strong propulsion was observed at high energy/pulse resulting in increased mobility. Low repetition rates result in long destruction times. Hard calculi destruction takes a longer time compared to soft stones. In-vitro investigations on human stones (n=30) were performed using fluorescence spectrometer and fluorescence microscopy techniques. Urinary stones show broad band fluorescence emission. Inhomogeneous local fluorescence sites and homogeneous surface fluorescence can be distinguished. The impact of fluorescence guidance during endoscopic laser lithotripsy will be discussed. Specific laser parameter should be used for effective clinical stone destruction

© 2018 The Author(s)

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