Thulium fiber laser lithotripsy using small spherical distal fiber tips

Christopher R. Wilson, Luke A. Hardy, Joshua D. Kennedy, Pierce B. Irby, Nathaniel M. Fried

Research output: Chapter in Book/Report/Conference proceedingConference contribution

1 Scopus citations


This study tests a 100-μm-core fiber with 300-μm-diameter ball tip during Thulium fiber laser (TFL) lithotripsy. The TFL was operated at 1908 nm wavelength with 35-mJ pulse energy, 500-μs pulse duration, and 300-Hz pulse rate. Calcium oxalate/phosphate stone samples were weighed, laser procedure times measured, and ablation rates calculated for ball tip fibers, with comparison to bare tip fibers. Photographs of ball tips were taken before and after each procedure to observe ball tip degradation and determine number of procedures completed before need to replace fiber. Saline irrigation rates and ureteroscope deflection were measured with and without TFL fiber present. There was no statistical difference (P > 0.05) between stone ablation rates for single-use ball tip fiber (1.3 ± 0.4 mg/s) (n=10), multiple-use ball tip fiber (1.3 ± 0.5 mg/s) (n=44), and conventional single-use bare tip fibers (1.3 ± 0.2 mg/s) (n=10). Ball tip durability varied widely, but fibers averaged > 4 stone procedures before decline in stone ablation rates due to mechanical damage at front surface of ball tip. The small fiber diameter did not impact ureteroscope deflection or saline flow rates. The miniature ball tip fiber may provide a cost-effective design for safe fiber insertion through the ureteroscope working channel and the ureter without risk of scope damage or tissue perforation, and without compromising stone ablation efficiency during TFL ablation of kidney stones.

Original languageEnglish (US)
Title of host publicationPhotonic Therapeutics and Diagnostics XII
ISBN (Electronic)9781628419245
StatePublished - 2016
Externally publishedYes
EventPhotonic Therapeutics and Diagnostics XII - San Francisco, United States
Duration: Feb 13 2016Feb 14 2016


OtherPhotonic Therapeutics and Diagnostics XII
Country/TerritoryUnited States
CitySan Francisco


  • ablation
  • ball tip fibers
  • kidney stones
  • lithotripsy
  • thulium

ASJC Scopus subject areas

  • Atomic and Molecular Physics, and Optics
  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Radiology Nuclear Medicine and imaging


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