Effect of holmium:YAG laser pulse modulation on lithotripsy particle size: a bench study

Holmium:YAG laser is commonly used as an efficient technology for lithotripsy, breaking urinary stones into small particles (dust) and larger residual fragments (RF). One of the ultimate goals is to create fine dust for real-time aspiration, eliminating the need for mechanical retrieval of RFs. A recent study of stone dust definition suggests a maximum particle size of 250-µm to allow complete aspiration through the working channel of a flexible ureteroscope. We have evaluated the particle size generation of a concept Holmium:YAG laser utilizing a pulse width modulation technique. This technology delivers numerous low-energy micro-pulses per pulse with long temporal pulse duration to potentially enable finer dust particles, better ablation rate, and reduced retropulsion. Overall, the concept device generates a high percentage of fine dust compared with prior results found in literature. (Disclaimers: Bench Test results may not necessarily be indicative of clinical performance. The testing was performed by or on behalf of BSC. Data on file. Concept device or technology. Not available for sale. This device is not yet available for sale in the United States).