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Impacted broncholiths removed with the holmium: YAG laser
Author(s) -
McCaughan James S.,
Heinzmann Henry G.,
McMahon Deborah
Publication year - 1996
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/(sici)1096-9101(1996)19:2<230::aid-lsm16>3.0.co;2-a
Subject(s) - holmium , laser , forceps , lithotripsy , medicine , laser lithotripsy , surgery , suction , local anesthesia , endotracheal tube , intubation , optics , mechanical engineering , physics , engineering
Background and Objective Although the Nd:YAG laser has been used endoscopically to remove broncholiths, our experience with it for this purpose has been tedious and difficult. The calculus burns and partially vaporizes, but most of the removal has to be done mechanically with crushing from biopsy forceps. Laser lithotripsy for ureteral calculi has been reportod using the pulsed Holmium:YAG laser to fragment the calculus, and we evaluated the efficacy of this laser to remove impacted broncholiths. Study Design/Materials and Methods Two patients with impacted broncholiths obstructing segments of the right middle lobe were treated using a pulsed Holmium:YAG laser. General endotracheal anesthesia with an FIO 2 of 40% was used, and the laser energy was delivered through a 365‐μm bare tip fiber passed through the biopsy channel of a flexible bronchoscope inserted through the endotracheal tube. Results The calculi were easily fragmented and removed with suction. Conclusions The pulsed Holmium:YAG laser was an effective tool to fragment and remove impacted broncholiths with minimal side effects using 2 J and 5 Hertz. The calculi exploded into tiny fragments. © 1996 Wiley‐Liss, Inc.