Evaluation of 16 New Holmium:Yttrium-Aluminum-Garnet Laser Optical Fibers for Ureteroscopy

ObjectiveTo test the performance of 16 new single-use holmium:yttrium-aluminum-garnet (YAG) laser fibers.Materials and MethodsSmall and medium core fibers were evaluated for flexibility, true diameter, connector temperature, and failure threshold. A flexible ureteroscope was deflected with the fiber in the working channel to measure flexibility. Diameter was measured by micrometer and connector temperature by infrared thermometer. Failure threshold was determined by bending the fiber to 180°, beginning with a radius of 1.25 cm. A 100 W holmium:YAG laser was operated at 1.2 J/10 Hz for 30 seconds or until fiber fracture. The radius was decreased in 0.25-cm increments until a minimum bend radius of 0.4 cm was attained or until fiber fracture.ResultsOf the small core-fibers, the Cook-HLF-S150 (Cook Medical) had the smallest diameter and the Flexiva TracTip 200 (Boston Scientific) the largest. The Cook-HLF-S150 and S200 were the most flexible and the SlimLine EZ200 (Lumenis) the least. The SlimLine EZ200 failed at the largest bend radius, whereas the Flexiva 200 and Flexiva TracTip 200 did not fracture. Of the medium-core fibers, the ScopeSafe 300 had the smallest diameter and the Flexiva 365 the largest. The ScopeSafe 300 was the most flexible and the SlimLine 365 the least. The ScopeSafe 365 failed at the largest radius of 1.25 cm, and the Flexiva 365 did not fail in 6 of 9 trials at the tightest radius.ConclusionPerformance characteristics of these new holmium:YAG optical fibers differed significantly but performance was on par or better than historical controls.