Experimental Investigation of Neodymium-YAG Laser Induced Shock Waves for Lithotripsy

Technical Considerations Using a Pulsed Neodym-YAG Laser for Endoscopic Shock Wave Lithotripsy

“…argon, carbon dioxide, Neodym-YAG) cannot be used clinically for fragmenta tion of urinary calculi. They vaporize the surface of the calculus and the delivered energy necessary to produce urinary stone ablation causes significant thermic damage to the surrounding tissue [2,4,5]. Work with optome chanical couplers in combination with laser pulses proved to be technically insufficient [5].…”

“…dye laser, Neo dym-YAG) with brief pulse duration and high energy density resulted in sufficient fragmentation of the stone without significant damage to adjacent tissue [3,5,6], In these systems, the calculi are disintegrated by shock waves generated by laser-induced plasma formation. However, there is an important difference between the pulsed dye laser and the Q-switched Neodym-YAG la ser.…”

“…This is realized by the special shape of the fiber tip. The LIB due to the plasma formation results in the generation of shock waves in front of the stone [5,6] (fig. 1).…”

“…Recently, Schärfe et al [9] made the same observation using a different in vitro model. These findings seem to be of major importance since authors still recommend higher frequencies (40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50) for clinical use of the Q-switched Neodym-YAG laser [5,6], moved in concentric circles during laser tripsy ( fig. 2).…”

“…At the present, there are two laser modifications in clinical use: a pulsed dye laser [2][3][4]10], and a Qswitched Neodym-YAG laser [5][6][7]9].…”