Integrated dual-functional laser-electric optical fiber：A prototype device for urologic surgical procedures

Purpose We introduce an integrated optical fiber that can simultaneously transmit high-power laser energy and conduct electricity for urologic surgical procedures. Methods An integrated dual-functional laser–electric optical fiber was successfully developed based on a widely used medical high-energy optical fiber, modified with electrical components. This fiber can connect with a thulium laser and a bipolar plasma generator simultaneously. Using the fiber, an ex vivo simulation of transurethral vaporization of porcine kidney tissues was conducted in three groups (laser-plasma, laser, and plasma). Tissue removal efficiency was calculated using the weighing method, and tissue thermal damage was assessed by Hematoxylin and Eosin (H&E) staining. One-way analysis of variance (ANOVA) and least significant difference (LSD) test were used for statistical analysis. Results The integrated fiber is compatible with the laser resectoscope. In terms of tissue removal efficiency, the laser-plasma group had the highest [(0.433 ± 0.039) g/min] and the plasma group had the lowest, while there was no significant difference between the laser and plasma groups [(0.141 ± 0.017) vs (0.117 ± 0.052) g/min, p = 0.470]. For thermal damage, there was no significant difference between the laser-plasma and laser groups [(985.484 ± 178.509) vs (957.511 ± 197.375) µm, p = 0.602], but both were significantly higher than those in the plasma group [(499.639 ± 77.992) µm]. Conclusion A prototype of an integrated dual-functional laser-electric optical fiber was successfully developed. Compared with the laser or the plasma energy alone, the combined laser-plasma energy can vaporize kidney tissue more efficiently without additional thermal damage.