Use of an absorbent in laser lithotripsy with dye lasers: in vitro study of fragmentation efficiency and jet formation.

Abstract

Among other things, the fragmentation efficiency of laser lithotripsy using a dye laser depends upon the physical properties of the surface of the calculus, especially optical absorption. In this in vitro study we were able to increase the fragmentation efficiency on white, nonabsorbing calculi by introducing an absorbing liquid between the distal end of the fiber and the stone surface. This absorbing liquid (in our case potassium dichromate) provides a reliable plasma ignition and thus makes the fragmentation independent of the properties of the stone surface. Furthermore, we examined and documented the existence of liquid jets that were produced by the collapse of a cavitation bubble near a stone. We observed considerable fragmentation effects on artificial stones that were, however, inferior to those achieved with the fiber in contact with the stone. This work suggests that the effects of a liquid jet should be taken into consideration when using a holmium:YAG laser for lithotripsy.