germanium and Urinary-Calculi

During recent experimental studies, the erbium:YAG laser has been shown to be more efficient for lithotripsy and more precise for incision of soft urinary tissues than the conventional holmium:YAG laser. Mid-infrared optical fibers are being developed to allow endoscopic delivery of Er:YAG laser radiation. This paper describes the simple construction and characterization of a side-firing germanium oxide fiber for potential use with the Er:YAG laser in endourology.. The 450-microm-core side-firing fibers were constructed from germanium oxide fibers by polishing the distal tip at a 45 degrees angle and placing a protective quartz cap over the tip. The Er:YAG laser radiation, with a wavelength of 2.94 microm, was transmitted through the fibers.. The fiber transmission rate and damage threshold measured 48 +/- 4% and 149 +/- 37 mJ, respectively (n = 6 fibers). Sufficient pulse energies were transmitted through the side-firing fibers to produce contact tissue ablation.

Topics: Aluminum; Erbium; Fiber Optic Technology; Germanium; Humans; Laser Therapy; Lithotripsy, Laser; Optical Fibers; Urinary Calculi; Urologic Surgical Procedures; Yttrium

Previous studies have demonstrated that the erbium:YAG laser is two to three times more efficient for laser lithotripsy than the holmium:YAG laser. However, the lack of a suitable optical fiber delivery system remains a major obstacle to clinical application of Er:YAG laser lithotripsy. This paper describes the initial testing of a hybrid germanium oxide/silica optical fiber for potential endoscopic use with the Er:YAG laser.. Er:YAG laser radiation with a wavelength of 2.94 microm, a pulse energy of 10 to 600 mJ, a pulse length of 220 microsec, and pulse-repetition rates of 3 to 10 Hz was focused into either 350- or 425- microm-core hybrid germanium/silica fibers in contact with human uric acid or calcium oxalate monohydrate stones.. Average Er:YAG pulse energies of 157 +/- 46 mJ (66 J/cm(2)) (N = 8) were delivered at 10 Hz through the 425-microm hybrid fibers in contact with urinary stones before fiber damage was observed. A maximum pulse energy of 233 mJ (98 J/cm(2)) was also measured through the hybrid fiber in contact with the stones. These values are significantly greater than the stone ablation thresholds of 15 to 23 mJ (6-10 J/cm(2)) and the fiber damage thresholds measured for germanium oxide, 18 +/- 1 mJ (13 J/cm(2)), and sapphire, 73 mJ (51 J/cm(2)), optical fibers during Er:YAG laser lithotripsy (P < 0.05).. A prototype hybrid germanium/silica optical fiber demonstrated better performance than both germanium oxide and sapphire fibers for transmission of Er:YAG laser radiation during in vitro lithotripsy.

Topics: Aluminum Oxide; Erbium; Fiber Optic Technology; Germanium; Humans; In Vitro Techniques; Lithotripsy, Laser; Optical Fibers; Silicon Dioxide; Urinary Calculi