Research on the Efficiency and Safety of the Pulse Thulium Fiber Laser Lithotripsy through model Experimental

Objective This study aims to investigate the physical interaction characteristics of thulium fiber laser (TFL) lithotripsy, to elucidate the influence of laser parameters on stone ablation efficiency and clinical safety, and thereby to guide the clinical application. Methods The experiment was established to investigate the laws of laser penetration depth and environmental water temperature rise under different condition. The potential for radiation and thermal damage to surrounding tissues was analyzed based on these laws. Concurrently, lithotripsy efficiency of different laser parameters was investigated by experiment. Results The laser penetration depth exceeding 5 mm in water if the long pulse width is over 1 ms, which poses a risk of radiative damage to surrounding tissues. When the TFL average power exceeds 30 W with insufficient irrigation its rate being lower than 40 mL/min, a rapid temperature rise surpassing 47℃ occurs and creating a risk of thermal injury to adjacent tissues. Furthermore, a pulse width greater than 500 µs is generally required to achieve high lithotripsy efficiency. Conclusion The lithotripsy efficiency of TFL is directly influenced by pulse width and power. However, since both long pulse widths and high average power can pose risks of damage to surrounding tissues, parameter optimization is important during TFL procedures.