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Intracorporeal lithotripsy with the Alexandrite laser
Author(s) -
Denstedt John D.,
Chun Samuel S.,
Miller M. Dale,
Eberwein Parker M.
Publication year - 1997
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(1997)20:4<433::aid-lsm9>3.0.co;2-r
Subject(s) - medicine , laser lithotripsy , lithotripsy , laser , surgery , ureteroscopy , perforation , dye laser , percutaneous , ureter , optics , punching , physics , materials science , metallurgy
Background and Objective The objective of this study was to evaluate clinical use of an Alexandrite laser lithotripter for intracorporeal lithotripsy of urinary calculi. Study Design/Materials and Methods: We prospectively evaluated a flash lamp pumped, Q‐switched Alexandrite solid‐state laser for use in conjunction with ureteroscopy (30 cases) or percutaneous nephrolithotripsy (2 cases). The laser operates at a wavelength of 755 nm in a pulsed mode with pulses of 150–800 ns duration at energy settings of 30–80 mJ. Results The fragmentation rate with the Alexandrite laser alone was 50% (16/32). Failure of the laser was due to equipment malfunction or technical problems in 11 cases and inability to fragment the stone in 5. All cases of failed Alexandrite laser lithotripsy were successfully salvaged with alternative modalities of endoscopic stone destruction and removal. One intraoperative complication, a ureteral perforation, occurred; however, no long‐term sequelae related to laser use was documented. Conclusion Clinical results with the Alexandrite laser appear to be inferior to those reported with alternative laser systems and other forms of intracorporeal lithotripsy. Whereas some of the inadequacies we have noted may be addressed in the future by modifications in the unit and delivery systems, we would not recommend this device for intracorporeal lithotripsy of urinary calculi in its current form. Lasers Surg. Med. 20:433–436, 1997. © 1997 Wiley‐Liss, Inc.