Comparison of Sapphire and Germanium Fibers for Erbium: YYYYag Lithotripsy

We studied the sapphire and germanium fibers to determine which optical fiber best transmits Erbium:YAG laser for intracorporeal lithotripsy. Human calculi were ablated with an Erbium:YAG laser in contact mode using two fibers. Optical outputs at the distal end of fibers were measured before and after laser lithotripsy. Upon the irradiation on the calculus with the 50 mJ and 100 mJ pulse energy, the output energy at the distal end of germanium fiber declined to approximately 50% of the input energy. For the sapphire fiber, the output energy at the distal end remained unchanged with 100 mJ input energy; however the output energy had dropped to 50% for 200 mJ input energy. In order to examine how the types of target tissue affect the fiber damage, the sapphire fiber was tested for the irradiation on soft tissue and water as well. No energy decline was observed during soft tissue and water irradiation. We also characterized ablation craters with both optical fibers. Both fibers produced similar craters on calculi in terms of depth and diameter. Sapphire fibers are better suited than germanium fibers for Erbium:YAG lithotripsy in terms of the fiber damage.