Comparison of Holmium:YAG and Thulium Fiber Lasers on the Risk of Laser Fiber Fracture
Objectives: To compare the risk of laser fiber fracture between Ho:YAG laser and Thulium Fiber Laser (TFL) with different laser fiber diameters, laser settings, and fiber bending radii. METHODS: Lengths of 200, 272, and 365 μm single use fibers were used with a 30 W Ho:YAG laser and a 50 W Super Pul...
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doaj-76c7eb9ff1a140e28ffca962469f57e92021-07-15T15:39:32ZengMDPI AGJournal of Clinical Medicine2077-03832021-06-01102960296010.3390/jcm10132960Comparison of Holmium:YAG and Thulium Fiber Lasers on the Risk of Laser Fiber FractureAudrey Uzan0Paul Chiron1Frédéric Panthier2Mattieu Haddad3Laurent Berthe4Olivier Traxer5Steeve Doizi6Sorbonne Université, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, F-75020 Paris, FranceSorbonne Université, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, F-75020 Paris, FranceSorbonne Université, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, F-75020 Paris, FranceSorbonne Université, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, F-75020 Paris, FrancePIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l’Hôpital, F-75013 Paris, FranceSorbonne Université, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, F-75020 Paris, FranceSorbonne Université, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, F-75020 Paris, FranceObjectives: To compare the risk of laser fiber fracture between Ho:YAG laser and Thulium Fiber Laser (TFL) with different laser fiber diameters, laser settings, and fiber bending radii. METHODS: Lengths of 200, 272, and 365 μm single use fibers were used with a 30 W Ho:YAG laser and a 50 W Super Pulsed TFL. Laser fibers of 150 µm length were also tested with the TFL only. Five different increasingly smaller bend radii were tested: 1, 0.9, 0.75, 0.6, and 0.45 cm. A total of 13 different laser settings were tested for the Ho:YAG laser: six fragmentation settings with a short pulse duration, and seven dusting settings with a long pulse duration. A total of 33 different laser settings were tested for the TFL. Three laser settings were common two both lasers: 0.5 J × 12 Hz, 0.8 J × 8 Hz, 2 J × 3 Hz. The laser was activated for 5 min or until fiber fracture. Each measurement was performed ten times. Results: While fiber failures occurred with all fiber diameters with Ho:YAG laser, none were reported with TFL. Identified risk factors of fiber fracture with the Ho:YAG laser were short pulse and high energy for the 365 µm fibers (<i>p</i> = 0.041), but not for the 200 and 272 µm fibers (<i>p</i> = 1 and <i>p</i> = 0.43, respectively). High frequency was not a risk factor of fiber fracture. Fiber diameter also seemed to be a risk factor of fracture. The 200 µm fibers broke more frequently than the 272 and 365 µm ones (<i>p</i> = 0.039). There was a trend for a higher number of fractures with the 365 µm fibers compared to the 272 µm ones, these occurring at a larger bend radius, but this difference was not significant. Conclusion: TFL appears to be a safer laser regarding the risk of fiber fracture than Ho:YAG when used with fibers in a deflected position.https://www.mdpi.com/2077-0383/10/13/2960Ho:YAG laserthulium fiber laserlaser fiberlithotripsyurolithiasisureteroscopy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Audrey Uzan Paul Chiron Frédéric Panthier Mattieu Haddad Laurent Berthe Olivier Traxer Steeve Doizi |
spellingShingle |
Audrey Uzan Paul Chiron Frédéric Panthier Mattieu Haddad Laurent Berthe Olivier Traxer Steeve Doizi Comparison of Holmium:YAG and Thulium Fiber Lasers on the Risk of Laser Fiber Fracture Journal of Clinical Medicine Ho:YAG laser thulium fiber laser laser fiber lithotripsy urolithiasis ureteroscopy |
author_facet |
Audrey Uzan Paul Chiron Frédéric Panthier Mattieu Haddad Laurent Berthe Olivier Traxer Steeve Doizi |
author_sort |
Audrey Uzan |
title |
Comparison of Holmium:YAG and Thulium Fiber Lasers on the Risk of Laser Fiber Fracture |
title_short |
Comparison of Holmium:YAG and Thulium Fiber Lasers on the Risk of Laser Fiber Fracture |
title_full |
Comparison of Holmium:YAG and Thulium Fiber Lasers on the Risk of Laser Fiber Fracture |
title_fullStr |
Comparison of Holmium:YAG and Thulium Fiber Lasers on the Risk of Laser Fiber Fracture |
title_full_unstemmed |
Comparison of Holmium:YAG and Thulium Fiber Lasers on the Risk of Laser Fiber Fracture |
title_sort |
comparison of holmium:yag and thulium fiber lasers on the risk of laser fiber fracture |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-06-01 |
description |
Objectives: To compare the risk of laser fiber fracture between Ho:YAG laser and Thulium Fiber Laser (TFL) with different laser fiber diameters, laser settings, and fiber bending radii. METHODS: Lengths of 200, 272, and 365 μm single use fibers were used with a 30 W Ho:YAG laser and a 50 W Super Pulsed TFL. Laser fibers of 150 µm length were also tested with the TFL only. Five different increasingly smaller bend radii were tested: 1, 0.9, 0.75, 0.6, and 0.45 cm. A total of 13 different laser settings were tested for the Ho:YAG laser: six fragmentation settings with a short pulse duration, and seven dusting settings with a long pulse duration. A total of 33 different laser settings were tested for the TFL. Three laser settings were common two both lasers: 0.5 J × 12 Hz, 0.8 J × 8 Hz, 2 J × 3 Hz. The laser was activated for 5 min or until fiber fracture. Each measurement was performed ten times. Results: While fiber failures occurred with all fiber diameters with Ho:YAG laser, none were reported with TFL. Identified risk factors of fiber fracture with the Ho:YAG laser were short pulse and high energy for the 365 µm fibers (<i>p</i> = 0.041), but not for the 200 and 272 µm fibers (<i>p</i> = 1 and <i>p</i> = 0.43, respectively). High frequency was not a risk factor of fiber fracture. Fiber diameter also seemed to be a risk factor of fracture. The 200 µm fibers broke more frequently than the 272 and 365 µm ones (<i>p</i> = 0.039). There was a trend for a higher number of fractures with the 365 µm fibers compared to the 272 µm ones, these occurring at a larger bend radius, but this difference was not significant. Conclusion: TFL appears to be a safer laser regarding the risk of fiber fracture than Ho:YAG when used with fibers in a deflected position. |
topic |
Ho:YAG laser thulium fiber laser laser fiber lithotripsy urolithiasis ureteroscopy |
url |
https://www.mdpi.com/2077-0383/10/13/2960 |
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