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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 2: So what happened?
AccuFlex AccuTrac advantages of quartz Duotome Flexiva GreenLight Holmium Fiber holmium laser fiber karl storz laser fiber Laser Lithotripsy litho laser Lumenis medilase medilase H20 OmniPulse Optifiber ProFlex ProFlex LLF richard wolf Single Use LLF IFU stonelight Thulium thulium laser yellowstone
So what happened? At the time IQinc was sold, in 2006, we had been making SureFlex™ for a decade since the original BlackHole™ single use design was released. SureFlex had gone through multiple generations of design improvements as described in four US patents, now owned by Boston Scientific. We'd demonstrated to a Lumenis VP that we could deliver 100W from their VersaPulse laser, through our true 200 micron fiber while in a less than a 10mm bend radius: we labeled that fiber, the LLF200TG flagship fiber, at 50W maximum Ho:YAG for routine use. Heck, in an attempt to blow the Lumenis executive away,...
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...