What is the mechanism of action of laser lithotripsy?
Mar 18, 2022
Source: Cainiu Health
Dr. Wang Jianlong
Introduction
The mechanism of laser lithotripsy involves delivering laser energy through an optical fiber to the surface of the stone. The filtered portion of the laser light is absorbed by the stone’s surface, generating plasma. This plasma, upon absorbing invisible infrared light, instantaneously converts the laser energy into mechanical shock waves that fragment the stone.
Kidney stones are a condition that can cause severe pain. In addition to medication and surgical intervention, laser lithotripsy offers an effective method for breaking down stones and facilitating their natural expulsion from the body. Combined with appropriate post-procedural care and medical management, most patients with kidney stones achieve full recovery.
What is the mechanism of action of laser lithotripsy?
In laser lithotripsy, laser energy is delivered via an optical fiber directly onto the stone’s surface. The stone absorbs part of the laser light, generating plasma at the interface. Upon absorbing invisible infrared radiation, this plasma rapidly converts the laser energy into mechanical shockwaves, which fragment the stone. As a mechanical form of lithotripsy, laser lithotripsy features minimal tissue penetration—no more than 0.8 mm—thereby reducing thermal injury and lowering the risk of stone migration compared to pneumatic lithotripsy.
The laser fiber must be in direct contact with the stone surface; inadvertent contact with surrounding tissues (e.g., ureter or renal pelvis) may potentially cause perforation. However, current evidence does not conclusively demonstrate an increased incidence of postoperative ureteral stricture attributable to this technique.
Stone fragmentation typically begins at the periphery rather than the center, enabling progressive disintegration while minimizing complications. During irrigation, pressure and flow rate should be kept as low as possible while still maintaining adequate visualization.
Laser lithotripsy is essentially a minimally invasive procedure—a type of “in-body gravel removal” technique—in which a laser source is introduced directly to the stone site within the body, delivering high-energy laser pulses to fragment the stone. Various laser types exist, but flexible ureteroscopy combined with laser lithotripsy is the most widely used modality in urological stone management.
We hope the above information is helpful to you. Wishing you a happy and healthy life!
