title: Laser fiber cleaving techniques: effects on tip morphology and power output.
abstract: OBJECTIVE
  Proper cleaving of reusable laser fibers is needed to maintain optimal functionality. This study quantifies the effect of different cleaving tools on power output of the holmium laser fiber and demonstrates morphologic changes using microscopy.
  
  
  METHODS
  The uncleaved tips of new 272 μm reusable laser fibers were used to obtain baseline power transmission values at 3 W (0.6 J, 5 Hz). Power output for each of four cleaving techniques-11-blade scalpel, scribe pen cleaving tool, diamond cleaving wheel, and suture scissors-was measured in a single-blinded fashion. Dispersion of light from the fibers was compared with manufacturer specifications and rated as "ideal," "acceptable," or "unacceptable" by blinded reviewers. The fiber tips were also imaged using confocal and scanning electron microscopy. Independent samples Kruskal-Wallis test and chi square were used for statistical analysis (α<0.05).
  
  
  RESULTS
  New uncleaved fiber tips transmitted 3.04 W of power and were used as a reference (100%). The scribe pen cleaving tool produced the next highest output (97.1%), followed by the scalpel (83.4%), diamond cleaving wheel (77.1%), and suture scissors (61.7%), a trend that was highly significant (P<0.001). On pairwise comparison, no difference in power output was seen between the uncleaved fiber tips and those cleaved with the scribe pen (P=1.0). The rating of the light dispersion patterns from the different cleaving methods followed the same trend as the power output results (P<0.001). Microscopy showed that the scribe pen produced small defects along the fiber cladding but maintained a smooth, flat core surface. The other cleaving techniques produced defects on both the core and cladding.
  
  
  CONCLUSIONS
  Cleaving techniques produce a significant effect on the initial power transmitted by reusable laser fibers. The scribe pen cleaving tool produced the most consistent and highest average power output.
authors: Department of Urology, Loma Linda University Medical Center , Loma Linda, California.
authors: Janna M
authors: JM
authors: Vassantachart
authors: Michelle
authors: M
authors: Lightfoot
authors: Alexander
authors: A
authors: Yeo
authors: Jonathan
authors: J
authors: Maldonado
authors: Roger
authors: R
authors: Li
authors: Muhannad
authors: M
authors: Alsyouf
authors: Jacob
authors: J
authors: Martin
authors: Michael
authors: M
authors: Lee
authors: Gaudencio
authors: G
authors: Olgin
authors: D Duane
authors: DD
authors: Baldwin
mesh_terms: D018130:Diamond; D006801:Humans; D053844:Lasers, Solid-State; D017602:Lithotripsy, Laser / Q000295:instrumentation*; D018613:Microscopy, Confocal; D008855:Microscopy, Electron, Scanning; D013525:Surgical Instruments
chemical_list: D018130:Diamond