Characterization of a prototype miniature digital ureteroscope tip for enabling office-based thulium fiber laser lithotripsy

Laser lithotripsy is performed in a hospital operating room at high cost. Many lower ureter stones could potentially be treated in a less expensive, office-based procedure, if smaller ureteroscopes were available. Thulium fiber laser lithotripsy enables use of smaller (50-150-µm-core) optical fibers than Holmium:YAG laser lithotripsy, saving cross-sectional space within the working channel for exploitation in developing smaller ureteroscopes. A prototype, miniature, flexible, 40k digital ureteroscope tip was tested. Calibration, lighting, imaging, saline irrigation rate studies, and saline temperature safety studies were performed using a porcine ureter model, ex vivo.