title: Femtosecond laser lithotripsy: feasibility and ablation mechanism.
abstract: Light emitted from a femtosecond laser is capable of plasma-induced ablation of various materials. We tested the feasibility of utilizing femtosecond-pulsed laser radiation (lambda=800 nm, 140 fs, 0.9 mJ/pulse) for ablation of urinary calculi. Ablation craters were observed in human calculi of greater than 90% calcium oxalate monohydrate (COM), cystine (CYST), or magnesium ammonium phosphate hexahydrate (MAPH). Largest crater volumes were achieved on CYST stones, among the most difficult stones to fragment using Holmium:YAG (Ho:YAG) lithotripsy. Diameter of debris was characterized using optical microscopy and found to be less than 20 microm, substantially smaller than that produced by long-pulsed Ho:YAG ablation. Stone retropulsion, monitored by a high-speed camera system with a spatial resolution of 15 microm, was negligible for stones with mass as small as 0.06 g. Peak shock wave pressures were less than 2 bars, measured by a polyvinylidene fluoride (PVDF) needle hydrophone. Ablation dynamics were visualized and characterized with pump-probe imaging and fast flash photography and correlated to shock wave pressures. Because femtosecond-pulsed laser ablates urinary calculi of soft and hard compositions, with micron-sized debris, negligible stone retropulsion, and small shock wave pressures, we conclude that the approach is a promising candidate technique for lithotripsy.
authors.affiliation: The University of Texas at Austin, Department of Biomedical Engineering, 107 West Dean Keeton, Austin, Texas 78712, USA.
authors.forename: Jinze
authors.initials: J
authors.lastname: Qiu
authors.forename: Joel M H
authors.initials: JM
authors.lastname: Teichman
authors.forename: Tianyi
authors.initials: T
authors.lastname: Wang
authors.forename: Joseph
authors.initials: J
authors.lastname: Neev
authors.forename: Randolph D
authors.initials: RD
authors.lastname: Glickman
authors.forename: Kin Foong
authors.initials: KF
authors.lastname: Chan
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Milner
mesh_terms: D017076:Computer-Aided Design; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005240:Feasibility Studies; D017602:Lithotripsy, Laser / Q000295:instrumentation*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity