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“All Holmium Laser Fibers are the Same, Right?” Part 5: Beyond Air Well Terminations
AccuFlex AccuTrac ACMI laser fiber calculase EndoBeam Flexiva Holmium Fiber Holmium Laser holmium laser fiber karl storz Laser Lithotripsy Lasersafe litho laser OmniPulse Optifiber ProFlex ProFlex LLF quanta laser richard wolf Scopesafe Slimline stonelight SureFlex Thulium thulium laser fiber Trimedyne yellowstone
FIGURE 1: Trimedyne Holmium Fiber Connector (1991 to Present) Another common termination had its genesis (for holmium laser fibers) at Trimedyne right around 1990 (U. S. Patent No. 5,179,610, Milburn, et al., Figure 1). Trimedyne’s solution is elegant; if a bit over the top for 80W. Knowing that the OmniPulse™ holmium laser presented a laser focal spot that is too large to couple to smaller fibers, and knowing that the laser focus tended to bloom and drift due to localized thermal gradients within the laser rod(s), Trimedyne’s engineers decided to capture and reroute the energy that overfilled the Fiber Aperture....
All Holmium Laser Fibers are the Same, Right? Pt.4 -- Fiber Design Evolution
AccuFlex AccuTrac ACMI laser fiber dornier EndoBeam Flexiva Holmium Fiber Holmium Laser holmium laser fiber laser fiber Laser Lithotripsy Lasersafe litho laser Lumenis medilase medilase H20 OmniPulse Optifiber ProFlex ProFlex LLF quanta laser richard wolf Scopesafe Slimline stonelight SureFlex thulium laser fiber Trimedyne yellowstone
Part 4: Fiber Design Evolution -- the early days as reflected in today's products First and foremost, for differentiation among holmium laser fibers, is the issue of fiber dimensions. Frankly, I am astonished at the lack of clarity or standardization in identifying fiber sizes within this industry. Almost all “200 micron” fibers are actually much larger than 200 microns; not as egregiously large as described in some of the urological literature, where total fiber diameters are reported as opposed to the fiber core diameters used by manufacturers, but definitely misleading to the point where incredulity dominates. I’ll have more on fiber sizes in...
All Holmium Laser Fibers are the Same, Right? Part 3: Pulsar HPC Introduction
AccuFlex AccuTrac ACMI laser fiber calculase EndoBeam Fiber Flexiva Holmium Fiber Holmium Laser holmium laser fiber karl storz laser fiber Laser Lithotripsy Lasersafe litho laser medilase medilase H20 OmniPulse Optifiber ProFlex ProFlex LLF ProGlide quanta laser richard wolf Scopesafe SideLite Slimline stonelight SureFlex thulium laser Trimedyne yellowstone
Before updating this entry, a reader asked a question about a statement I'd made about the flexibility of the Boston Scientific holmium fibers AccuMax™ and Flexiva™ that I answered in the updated Part 2 entry. I am leaving my answer to that question in this entry, for congruity. Pardon the redundancy. Q: ‘How do you know Boston’s AccuMax™ and Flexiva™ are stiffer than ProFlex 200 if, as you say, you’ve never seen one of Boston’s fibers?’ A: Updated answer -- we measured the glass OD of the Boston fibers and, as expected, it is 290 microns (242 microns x 1.2 CCDR). This...
All Holmium Laser Fibers are the Same, Right? Part 1: An Introduction
AccuFlex AccuTrac ACMI laser fiber calculase dornier EndoBeam Flexiva Holmium Fiber holmium laser holmium laser fiber karl storz laser fiber Laser Lithotripsy Lasersafe litho laser Lumenis medilase medilase H20 OmniPulse Optifiber ProFlex LLF quanta laser richard wolf Scopesafe Slimline stonelight SureFlex Thulium thulium laser thulium laser fiber yellowstone
Stephen’s Law of Advancing Technology: Without a leader in innovation, product designs converge. Corollary to Stephen’s Law: Dollar-driven designs approach minimum acceptable performance. A tale of two fibers – it’s not the best quality; it’s not the worst quality (upper left -- connector with huge glue ring, steel tube, glass ferrule and the fiber in the very center; upper right -- close-up of fiber input; lower left -- close-up of working tip; lower right -- comet on output of working tip) While the above is not proof of “Stephen's Law”, it sure supports it. I’m Stephen. The photo series...
A Practical Guide to Producing Safe & Efficient Surgical Fiber Working Tips
cutting fiber EndoBeam Holmium Fiber laser fiber Laser Lithotripsy OmniPulse Optifiber ProFlex LLF Scopesafe Slimline
Tip failure occurs more rapidly where the tip begins with flaws, particularly where the optical output of the fiber is distorted. Most instructions for reproducing fiber tips are crude and non-scientific; “stripping and cleaving” instructions found on the internet, within other fiber manufacturers’ websites and IFUs typically yield highly variable and suboptimum results. The following guide represents best practices in producing fiber working tips and is based upon the science of Fracture Mechanics. It is provided as a supplement to the full ProFlex™ LLF IFU and is intended for use by non-surgical personnel who are routinely charged with reproducing working tips on...