Biological consequences of fiber fragmentation with pulsed laser lithotripsy

E. W. Bruhn, Pmnyh Go, R. W. McClane, J. G. Hunter, R. C. Straight

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

2 Scopus citations

Abstract

Fiber tip breakage during urinary and biliary laser lithotripsy has been recognized to occur with several laser types. This phenomenon has also been seen with Q-switched Nd:YAG laser lithotripsy. Our aim was to determine the biological consequences of this event in the canine ureter and bile duct. In an excised tissue preparation, urinary and biliary stones were impacted in a canine ureter and common bile duct. Three and four hundred micron quartz laser fibers were placed in direct contact with the stone. Normal saline coaxial irrigation was initiated at 75 ml/min. A Q-switched Nd:YAG laser was activated at repetition rates from 10-30 Hz. and pulse energies from 10-30 mJ. The tissue was sectioned and microscopic examination of the fragmentation site was performed. Histological exam revealed the persistence of large numbers of fiber fragments in the lumen and imbedded in the epithelium at the lithotripsy site. Fragments varied greatly in size and appeared to have angular, sharp edges. We conclude that irrigation can not be relied upon to remove the fiber fragments from the lithotripsy sites and that the biological consequences of fiber fragmentation may be greater than previously believed. Glass fragments 'blown' into the epithelium will often result in glass granulomas, which may eventually cause obstruction of closed luminal structures. This raises serious concern for the presence of any fiber breakage during laser lithotripsy.

Original languageEnglish (US)
Title of host publicationProceedings of SPIE - The International Society for Optical Engineering
PublisherPubl by Int Soc for Optical Engineering
Pages90-93
Number of pages4
ISBN (Print)0819402419, 9780819402417
DOIs
StatePublished - Jan 1 1990
EventProceedings of Laser Surgery: Advanced Characterization Therapeutics, and Systems II - Los Angeles, CA, USA
Duration: Jan 14 1990Jan 19 1990

Publication series

NameProceedings of SPIE - The International Society for Optical Engineering
Volume1200
ISSN (Print)0277-786X

Other

OtherProceedings of Laser Surgery: Advanced Characterization Therapeutics, and Systems II
CityLos Angeles, CA, USA
Period1/14/901/19/90

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Condensed Matter Physics
  • Computer Science Applications
  • Applied Mathematics
  • Electrical and Electronic Engineering

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  • Cite this

    Bruhn, E. W., Go, P., McClane, R. W., Hunter, J. G., & Straight, R. C. (1990). Biological consequences of fiber fragmentation with pulsed laser lithotripsy. In Proceedings of SPIE - The International Society for Optical Engineering (pp. 90-93). (Proceedings of SPIE - The International Society for Optical Engineering; Vol. 1200). Publ by Int Soc for Optical Engineering. https://doi.org/10.1117/12.17444