ABSTRACT
Calculus migration is a common problem during ureteroscopic laser lithotripsy procedure to treat urolithiasis. A conventional experimental method to characterize calculus migration utilized a hosting container (e.g., a "V" grove or a test tube). These methods, however, demonstrated large variation and poor detectability, possibly attributed to the friction between the calculus and the container on which the calculus was situated. In this study, calculus migration was investigated using a pendulum model suspended underwater to eliminate the aforementioned friction. A high-speed camera was used to study the movement of the calculus which covered zero order (displacement), first order (speed), and second order (acceleration). A commercialized, pulsed Ho:YAG laser at 2.1 µm, a 365-µm core diameter fiber, and a calculus phantom (Plaster of Paris, 10 × 10 × 10 mm3) was utilized to mimic laser lithotripsy procedure. The phantom was hung on a stainless steel bar and irradiated by the laser at 0.5, 1.0, and 1.5 J energy per pulse at 10 Hz for 1 s (i.e., 5, 10, and 15 W). Movement of the phantom was recorded by a high-speed camera with a frame rate of 10,000 FPS. The video data files are analyzed by MATLAB program by processing each image frame and obtaining position data of the calculus. With a sample size of 10, the maximum displacement was 1.25 ± 0.10, 3.01 ± 0.52, and 4.37 ± 0.58 mm for 0.5, 1, and 1.5 J energy per pulse, respectively. Using the same laser power, the conventional method showed <0.5 mm total displacement. When reducing the phantom size to 5 × 5 × 5 mm3 (one eighth in volume), the displacement was very inconsistent. The results suggested that using the pendulum model to eliminate the friction improved sensitivity and repeatability of the experiment. A detailed investigation on calculus movement and other causes of experimental variation will be conducted as a future study.
Subject(s)
Calculi/pathology , Lasers, Solid-State , Lithotripsy, Laser/instrumentation , Lithotripsy, Laser/methods , Photography/instrumentation , Humans , Lasers, Solid-State/therapeutic use , Phantoms, ImagingABSTRACT
Q-switched (QS) Tm:YAG laser ablation mechanisms on urinary calculi are still unclear to researchers. Here, dependence of water content in calculus phantom on calculus ablation performance was investigated. White gypsum cement was used as a calculus phantom model. The calculus phantoms were ablated by a total 3-J laser pulse exposure (20 mJ, 100 Hz, 1.5 s) and contact mode with N=15 sample size. Ablation volume was obtained on average 0.079, 0.122, and 0.391 mm3 in dry calculus in air, wet calculus in air, and wet calculus in-water groups, respectively. There were three proposed ablation mechanisms that could explain the effect of water content in calculus phantom on calculus ablation performance, including shock wave due to laser pulse injection and bubble collapse, spallation, and microexplosion. Increased absorption coefficient of wet calculus can cause stronger spallation process compared with that caused by dry calculus; as a result, higher calculus ablation was observed in both wet calculus in air and wet calculus in water. The test result also indicates that the shock waves generated by short laser pulse under the in-water condition have great impact on the ablation volume by Tm:YAG QS laser.
