An Er:YAG laser endoscopic fiber delivery system for lithotripsy of salivary stones

Raif, Joshua; Vardi, Michael; Nahlieli, Oded; Gannot, Israel

doi:10.1002/lsm.20344

Cited by 71 publications

(71 citation statements)

References 33 publications

(30 reference statements)

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“…Intracorporal, electrohydraulic and piezoelectric lithotripsy (VII) has shown to have a fairly good fragmentation capability; the trade-off, however, is a high percentage of ductal perforations [16,17]. Endoscopic laser lithotripsy of salivary stones (VIII) has rarely been published so far as there is a lack of experience [5,8,[18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

“…Though first reports on laser lithotripsy of salivary stones using the excimer- [19,22], the pulsed-dye laser [8,20] and the CO 2 laser [18] date back to the early 1990s, only some single case studies have been published since then [5,24]. Newer laser systems such as the Ho:YAG and the Er:YAG laser, both with low risk of tissue damage and good fragmentation rates of uroliths [25,27], have only recently been investigated in sialolithiasis [23]. Another development in laser lithotripters is the FREDDY Laser, which is expected to carry an extremely low risk of tissue damage due to the low absorption of the laser pulses by the tissue at this wavelength [35,37,38].…”

Section: Introductionmentioning

confidence: 99%

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Laser induced fragmentation of salivary stones: An in vitro comparison of two different, clinically approved laser systems

et al. 2008

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This study clearly demonstrated the different processes of destroying salivary stones using two different laser systems. While the Ho:YAG vaporises the calculi in a more milling and soft sense, the FREDDY shows a more cracking and explosive destruction. Although both laser systems showed little direct risk to the surrounding tissue, it has to be proven whether cracked and accelerated particles could cause harm to soft tissue. With respect to this, further in vitro studies and clinical treatments in selected cases are needed to proof these results.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laser induced fragmentation of salivary stones: An in vitro comparison of two different, clinically approved laser systems

et al. 2008

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“…This imposes a mechanical limit on the maximum core diameter of the fiber. For example, such bend radii are only possible with solid core sapphire fibers with core diameters below 600 µm which then imposes a damage threshold on the fiber [15] ultimately limiting the maximum deliverable energy. Fluoride glass fibers with an attenuation of ∼0.2 dB/m provide a promising alternative, the state-of-the-art delivery systems with these fibers can achieve bend diameters of 20 cm [16] although the output beam profile does change with bending due to the multimode character.…”

Section: Flexible Delivery For Medical (Er:yag) Lasersmentioning

confidence: 99%

Silica hollow core microstructured fibers for beam delivery in industrial and medical applications

et al. 2015

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The focus of this review is recent work to develop microstructured hollow core fibers for two applications where the flexible delivery of a single mode beam is desired. Also, a brief review of other fiber based solutions is included. High power, short-pulsed lasers are widely used for micro-machining, providing high precision and high quality. However, the lack of truly flexible beam delivery systems limits their application to the processing of relatively small planar components. To address this, hollow-core optical fibers for the 1 µm and green wavelength ranges have been developed. The hollow core overcomes the power delivery limitations of conventional silica fibers arising from non-linear effects and material damage in the solid core. The fibers have been characterized in terms of power handling capability, damage threshold, bend loss and dispersion, and practically demonstrated delivery of high peak power pulses from the nanosecond to the femtosecond regime. Such fibers are ideal candidates for industrial laser machining applications. In laser surgical applications, meanwhile, an Er:YAG laser (2.94 µm) is frequently the laser of choice because the water contained in tissue strongly absorbs this wavelength. If this laser beam is precisely delivered damage to surrounding tissue can be minimized. A common delivery method of surgical lasers, for use in the operating theater, is articulated arms that are bulky, cumbersome and unsuitable for endoscopic procedures. To address this need for flexible mid-IR delivery silica based hollow core fibers have been developed. By minimizing the overlap of the light with glass it is possible to overcome the material absorption limits of silica and achieve low attenuation. Additionally, it is possible to deliver pulse energies suitable for the ablation of both hard and soft tissue even with very small bend radii. The flexibility and small physical size of systems based on these fibers will enable new minimally invasive surgical procedures.

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“…The majority of salivary stones range between 3 and 7 mm and can be managed using sialendoscopy, lithotripsy or laser fragmentation [24,25]. Larger (C8 mm) submandibular and parotid stones can be removed using the combined approach technique, which pairs stone localization by sialendoscopy with transoral or external removal of stone(s) [26, 27 •• , 28].…”

Section: Salivary Calculimentioning

confidence: 99%

Robotic Surgery for Salivary Gland Disease

Kane

Wilson

Walvekar

2014

Curr Otorhinolaryngol Rep

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Robotic surgery has revolutionized surgical capabilities and continues to change surgical approaches and management. Robotic surgery is in its infancy with respect to head and neck surgery. However, there are several validated indications for robotics in ENT. The authors discuss the role of robotic surgery specifically related to salivary gland disease and discuss the indications, complications and anatomic nuances that justify the current role and continued effort to expand indications for robotic surgery in the field of head and neck surgery.

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An Er:YAG laser endoscopic fiber delivery system for lithotripsy of salivary stones

Cited by 71 publications

References 33 publications

Laser induced fragmentation of salivary stones: An in vitro comparison of two different, clinically approved laser systems

Laser induced fragmentation of salivary stones: An in vitro comparison of two different, clinically approved laser systems

Silica hollow core microstructured fibers for beam delivery in industrial and medical applications

Robotic Surgery for Salivary Gland Disease

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