Plasma formation in holmium:YAG laser lithotripsy
Objectives During holmium:yttrium–aluminum–garnet (holmium:YAG) laser lithotripsy to break urinary stones, urologists frequently see flashes of light. As infrared laser pulses are invisible, what is the source of light? Here we studied the origin, characteristics, and some effects of flashes of ligh...
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| Veröffentlicht in: | Lasers in surgery and medicine 2023-07, Vol.55 (5), p.503-514 |
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| creator | Pishchalnikov, Yuri A. Behnke‐Parks, William M. Stoller, Marshall L. |
| description | Objectives
During holmium:yttrium–aluminum–garnet (holmium:YAG) laser lithotripsy to break urinary stones, urologists frequently see flashes of light. As infrared laser pulses are invisible, what is the source of light? Here we studied the origin, characteristics, and some effects of flashes of light in laser lithotripsy.
Methods
Ultrahigh‐speed video‐microscopy was used to record single laser pulses at 0.2–1.0 J energy lasered with 242 µm glass‐core‐diameter fibers in contact with whole surgically retrieved urinary stones and hydroxyapatite (HA)‐coated glass slides in air and water. Acoustic transients were measured with a hydrophone. Visible‐light and infrared photodetectors resolved temporal profiles of visible‐light emission and infrared‐laser pulses.
Results
Temporal profiles of laser pulses showed intensity spikes of various duration and amplitude. The pulses were seen to produce dim light and bright sparks with submicrosecond risetime. The spark produced by the intensity spike at the beginning of laser pulse generated a shock wave in the surrounding liquid. The subsequent sparks were in a vapor bubble and generated no shock waves. Sparks enhanced absorption of laser radiation, indicative of plasma formation and optical breakdown. The occurrence and number of sparks varied even with the same urinary stone. Sparks were consistently observed at laser energy >0.5 J with HA‐coated glass slides. The slides broke or cracked by cavitation with sparks in 63 ± 15% of pulses (1.0 J, N = 60). No glass‐slide breakage occurred without sparks (1.0 J, N = 500).
Conclusion
Unappreciated in previous studies, plasma formation with free‐running long‐pulse holmium:YAG lasers can be an additional physical mechanism of action in laser procedures. |
| doi_str_mv | 10.1002/lsm.23659 |
| format | Article |
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During holmium:yttrium–aluminum–garnet (holmium:YAG) laser lithotripsy to break urinary stones, urologists frequently see flashes of light. As infrared laser pulses are invisible, what is the source of light? Here we studied the origin, characteristics, and some effects of flashes of light in laser lithotripsy.
Methods
Ultrahigh‐speed video‐microscopy was used to record single laser pulses at 0.2–1.0 J energy lasered with 242 µm glass‐core‐diameter fibers in contact with whole surgically retrieved urinary stones and hydroxyapatite (HA)‐coated glass slides in air and water. Acoustic transients were measured with a hydrophone. Visible‐light and infrared photodetectors resolved temporal profiles of visible‐light emission and infrared‐laser pulses.
Results
Temporal profiles of laser pulses showed intensity spikes of various duration and amplitude. The pulses were seen to produce dim light and bright sparks with submicrosecond risetime. The spark produced by the intensity spike at the beginning of laser pulse generated a shock wave in the surrounding liquid. The subsequent sparks were in a vapor bubble and generated no shock waves. Sparks enhanced absorption of laser radiation, indicative of plasma formation and optical breakdown. The occurrence and number of sparks varied even with the same urinary stone. Sparks were consistently observed at laser energy >0.5 J with HA‐coated glass slides. The slides broke or cracked by cavitation with sparks in 63 ± 15% of pulses (1.0 J, N = 60). No glass‐slide breakage occurred without sparks (1.0 J, N = 500).
Conclusion
Unappreciated in previous studies, plasma formation with free‐running long‐pulse holmium:YAG lasers can be an additional physical mechanism of action in laser procedures.</description><identifier>ISSN: 0196-8092</identifier><identifier>EISSN: 1096-9101</identifier><identifier>DOI: 10.1002/lsm.23659</identifier><identifier>PMID: 36994818</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aluminum ; Cavitation ; Diameters ; Holmium ; holmium‐YAG laser ; Humans ; Hydrophones ; Hydroxyapatite ; Infrared detectors ; Infrared lasers ; laser lithotripsy ; Laser radiation ; Lasers ; Lasers, Solid-State - therapeutic use ; Light ; Light emission ; Lithotripsy ; Lithotripsy, Laser - methods ; optical breakdown ; Radiation ; Semiconductor lasers ; Shock waves ; Stone ; urinary calculi ; Urinary Calculi - therapy ; YAG lasers ; Yttrium</subject><ispartof>Lasers in surgery and medicine, 2023-07, Vol.55 (5), p.503-514</ispartof><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3889-45ba955831a1bf3d07034faeac7cc0dd9fc256af186bc23bfc0a56ed4a86f1373</citedby><cites>FETCH-LOGICAL-c3889-45ba955831a1bf3d07034faeac7cc0dd9fc256af186bc23bfc0a56ed4a86f1373</cites><orcidid>0000-0003-0277-3544</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flsm.23659$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flsm.23659$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36994818$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pishchalnikov, Yuri A.</creatorcontrib><creatorcontrib>Behnke‐Parks, William M.</creatorcontrib><creatorcontrib>Stoller, Marshall L.</creatorcontrib><title>Plasma formation in holmium:YAG laser lithotripsy</title><title>Lasers in surgery and medicine</title><addtitle>Lasers Surg Med</addtitle><description>Objectives
During holmium:yttrium–aluminum–garnet (holmium:YAG) laser lithotripsy to break urinary stones, urologists frequently see flashes of light. As infrared laser pulses are invisible, what is the source of light? Here we studied the origin, characteristics, and some effects of flashes of light in laser lithotripsy.
Methods
Ultrahigh‐speed video‐microscopy was used to record single laser pulses at 0.2–1.0 J energy lasered with 242 µm glass‐core‐diameter fibers in contact with whole surgically retrieved urinary stones and hydroxyapatite (HA)‐coated glass slides in air and water. Acoustic transients were measured with a hydrophone. Visible‐light and infrared photodetectors resolved temporal profiles of visible‐light emission and infrared‐laser pulses.
Results
Temporal profiles of laser pulses showed intensity spikes of various duration and amplitude. The pulses were seen to produce dim light and bright sparks with submicrosecond risetime. The spark produced by the intensity spike at the beginning of laser pulse generated a shock wave in the surrounding liquid. The subsequent sparks were in a vapor bubble and generated no shock waves. Sparks enhanced absorption of laser radiation, indicative of plasma formation and optical breakdown. The occurrence and number of sparks varied even with the same urinary stone. Sparks were consistently observed at laser energy >0.5 J with HA‐coated glass slides. The slides broke or cracked by cavitation with sparks in 63 ± 15% of pulses (1.0 J, N = 60). No glass‐slide breakage occurred without sparks (1.0 J, N = 500).
Conclusion
Unappreciated in previous studies, plasma formation with free‐running long‐pulse holmium:YAG lasers can be an additional physical mechanism of action in laser procedures.</description><subject>Aluminum</subject><subject>Cavitation</subject><subject>Diameters</subject><subject>Holmium</subject><subject>holmium‐YAG laser</subject><subject>Humans</subject><subject>Hydrophones</subject><subject>Hydroxyapatite</subject><subject>Infrared detectors</subject><subject>Infrared lasers</subject><subject>laser lithotripsy</subject><subject>Laser radiation</subject><subject>Lasers</subject><subject>Lasers, Solid-State - therapeutic use</subject><subject>Light</subject><subject>Light emission</subject><subject>Lithotripsy</subject><subject>Lithotripsy, Laser - methods</subject><subject>optical breakdown</subject><subject>Radiation</subject><subject>Semiconductor lasers</subject><subject>Shock waves</subject><subject>Stone</subject><subject>urinary calculi</subject><subject>Urinary Calculi - therapy</subject><subject>YAG lasers</subject><subject>Yttrium</subject><issn>0196-8092</issn><issn>1096-9101</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1LAzEQQIMotlYP_gFZ8KKHbScfm028laJVqCioB08hm03oyn7UZBfpv3d1qwfB0wzM4zE8hE4xTDEAmZWhmhLKE7mHxhgkjyUGvI_GgPtdgCQjdBTCGwBQAukhGlEuJRNYjBF-LHWodOQaX-m2aOqoqKN1U1ZFV129zpdRf7Y-Kot23bS-2ITtMTpwugz2ZDcn6OXm-nlxG68elneL-So2VAgZsyTTMkkExRpnjuaQAmVOW21SYyDPpTMk4dphwTNDaOYM6ITbnGnBHaYpnaCLwbvxzXtnQ6uqIhhblrq2TRcUSSWRwAiTPXr-B31rOl_33ykiCKOcccF76nKgjG9C8NapjS8q7bcKg_rqqPqO6rtjz57tjF1W2fyX_AnXA7MB-ChKu_3fpFZP94PyEw4Be2U</recordid><startdate>202307</startdate><enddate>202307</enddate><creator>Pishchalnikov, Yuri A.</creator><creator>Behnke‐Parks, William M.</creator><creator>Stoller, Marshall L.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0277-3544</orcidid></search><sort><creationdate>202307</creationdate><title>Plasma formation in holmium:YAG laser lithotripsy</title><author>Pishchalnikov, Yuri A. ; Behnke‐Parks, William M. ; Stoller, Marshall L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3889-45ba955831a1bf3d07034faeac7cc0dd9fc256af186bc23bfc0a56ed4a86f1373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aluminum</topic><topic>Cavitation</topic><topic>Diameters</topic><topic>Holmium</topic><topic>holmium‐YAG laser</topic><topic>Humans</topic><topic>Hydrophones</topic><topic>Hydroxyapatite</topic><topic>Infrared detectors</topic><topic>Infrared lasers</topic><topic>laser lithotripsy</topic><topic>Laser radiation</topic><topic>Lasers</topic><topic>Lasers, Solid-State - therapeutic use</topic><topic>Light</topic><topic>Light emission</topic><topic>Lithotripsy</topic><topic>Lithotripsy, Laser - methods</topic><topic>optical breakdown</topic><topic>Radiation</topic><topic>Semiconductor lasers</topic><topic>Shock waves</topic><topic>Stone</topic><topic>urinary calculi</topic><topic>Urinary Calculi - therapy</topic><topic>YAG lasers</topic><topic>Yttrium</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pishchalnikov, Yuri A.</creatorcontrib><creatorcontrib>Behnke‐Parks, William M.</creatorcontrib><creatorcontrib>Stoller, Marshall L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Lasers in surgery and medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pishchalnikov, Yuri A.</au><au>Behnke‐Parks, William M.</au><au>Stoller, Marshall L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Plasma formation in holmium:YAG laser lithotripsy</atitle><jtitle>Lasers in surgery and medicine</jtitle><addtitle>Lasers Surg Med</addtitle><date>2023-07</date><risdate>2023</risdate><volume>55</volume><issue>5</issue><spage>503</spage><epage>514</epage><pages>503-514</pages><issn>0196-8092</issn><eissn>1096-9101</eissn><abstract>Objectives
During holmium:yttrium–aluminum–garnet (holmium:YAG) laser lithotripsy to break urinary stones, urologists frequently see flashes of light. As infrared laser pulses are invisible, what is the source of light? Here we studied the origin, characteristics, and some effects of flashes of light in laser lithotripsy.
Methods
Ultrahigh‐speed video‐microscopy was used to record single laser pulses at 0.2–1.0 J energy lasered with 242 µm glass‐core‐diameter fibers in contact with whole surgically retrieved urinary stones and hydroxyapatite (HA)‐coated glass slides in air and water. Acoustic transients were measured with a hydrophone. Visible‐light and infrared photodetectors resolved temporal profiles of visible‐light emission and infrared‐laser pulses.
Results
Temporal profiles of laser pulses showed intensity spikes of various duration and amplitude. The pulses were seen to produce dim light and bright sparks with submicrosecond risetime. The spark produced by the intensity spike at the beginning of laser pulse generated a shock wave in the surrounding liquid. The subsequent sparks were in a vapor bubble and generated no shock waves. Sparks enhanced absorption of laser radiation, indicative of plasma formation and optical breakdown. The occurrence and number of sparks varied even with the same urinary stone. Sparks were consistently observed at laser energy >0.5 J with HA‐coated glass slides. The slides broke or cracked by cavitation with sparks in 63 ± 15% of pulses (1.0 J, N = 60). No glass‐slide breakage occurred without sparks (1.0 J, N = 500).
Conclusion
Unappreciated in previous studies, plasma formation with free‐running long‐pulse holmium:YAG lasers can be an additional physical mechanism of action in laser procedures.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36994818</pmid><doi>10.1002/lsm.23659</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-0277-3544</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Lasers in surgery and medicine, 2023-07, Vol.55 (5), p.503-514 |
| issn | 0196-8092 1096-9101 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aluminum Cavitation Diameters Holmium holmium‐YAG laser Humans Hydrophones Hydroxyapatite Infrared detectors Infrared lasers laser lithotripsy Laser radiation Lasers Lasers, Solid-State - therapeutic use Light Light emission Lithotripsy Lithotripsy, Laser - methods optical breakdown Radiation Semiconductor lasers Shock waves Stone urinary calculi Urinary Calculi - therapy YAG lasers Yttrium |
| title | Plasma formation in holmium:YAG laser lithotripsy |
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