Ureteroscopy with Holmium: YAG Laser—A Initial Study in the Urology Department of the Pr Bocar Sidy Sall University Hospital of Kati

Introduction: Ureteroscopy is a minimally invasive endoscopic surgery which provides access to the ureter, pyelon and calyceal cavities via the urethra and the bladder. Laser ureteroscopy uses the laser as an energy source to treat the stone and eliminate it naturally. Minimally invasive endoscopic methods are struggling to become popular in sub-Saharan African countries, especially for the upper urinary tract. The objective of our work was to report the results of our first laser ureteroscopy experience in the department. Materials and Methods: This was a prospective and descriptive study running from December 1, 2023 to February 19, 2024. Included in our study was any case of upper urinary tract stone operated by Laser ureteroscopy. The characteristics of the lithiasis were determined by CT scan. Sterilization of urine was verified by carrying out a cytobacteriological examination of urine. Ureteral lithiasis was approached by semi-rigid ureteroscopy. Renal lithiasis was immediately addressed by flexible ureteroscopy. Ureteroscopy was coupled with a Holmium YAG laser. A double J ureteral catheter was placed after the operation. A 230 µm laser fiber was used in each case with a generator with a power of 35 watts (Storz Calculase III type). An access sheath was used in all cases of flexible ureteroscopy. The parameters studied were: sociodemographic characteristics, lithiasis (site, size, number, density, topography), type of anesthesia, duration of laser use, duration of intervention, postoperative outcomes. Data entry and analysis were carried out using the software (Word 2016 and SPSS). Result: We collected 30 cases of laser ureteroscopy. The average age was 37 years with extremes of 9 and 79 years. The male gender was more represented. The most common age group was 24-39 years old. Renal colic was the most frequent reason for admission, 12 patients (40%). On physical examination, lumbar tenderness was present in 47% (14 patients). ECBU was positive in 4 patients (13%). CT scan was performed in all our patients before the intervention. The average stone size was 12 mm and the largest was 23 mm. The majority of stones, i.e. 59% (18 patients), had a density greater than 1000 HU. The stone was unique in 19 patients (63%). The location of the stone was pyelic in 8 patients or 27%. An impact on the upper urinary tract was found in 16 of our patients or 53%. General anesthesia was used in 25 patients (83%). A digital flexible ureteroscopy was used in 24 patients and a semi-rigid ureteroscopy (URS) in 6 patients. Full-course fragmentation was the most used therapeutic method, 9 patients or 32%. The average duration of interventions was 61 minutes. Drainage by double J catheter at the end of the procedure was performed in all our patients. The length of hospitalization was 24 hours. Only one case of failure in the USSR was recorded, and one case of failure was in the semi-rigid URS. Conclusion: Laser ureteroscopy is an effective minimally invasive surgery in the management of lithiasis of the upper urinary tract. It significantly reduces the length of hospitalization. Mastery of this technique and the acquisition of the equipment necessary for its implementation is an undeniable asset in the management of renal and ureteral lithiasis.

Long-term efficacy and safety of YAG laser vitreolysis for vision degrading myodesopsia

AIM:To assess the long-term efficacy and safety of yttrium-aluminum garnet(YAG)laser vitreolysis for vision degrading myodesopsia(VDM)caused by posterior vitreous detachment(PVD).METHODS:This retrospective study reviewed VDM patients of PVD type undergoing YAG laser vitreolysis.The baseline demographic information,the patterns of floaters,the number of floaters,and the subjective improvement of floater sympotoms(ranging from 0 to 100%)from medical records were collected.Significant improvement was defined as a relief of floater symptoms of≥50%at the final visit.The long-term efficacy and safety of YAG laser vitreolysis were analyzed.The risk factors linked to significant improvement of floater symptoms were defined using univariate and multivariate logistic regression analyses.RESULTS:The final analysis included 221 patients with VDM.The mean age of patients was 61.08±7.74y,and the mean length of follow-up was 21.38±5.61mo.Totally 57.01%of patients experienced a significant improvement in their floater symptoms after YAG laser therapy,and none of them developed delayed retinal abnormalities such as retinal tears or detachments.Age(OR=1.049,95%CI=1.007-1.092,P=0.021)was identified as a significant risk factor for significant improvement in VDM.CONCLUSION:YAG laser vitreolysis is an effective and secure treatment for PVD-type VDM,and patients of advanced age are more likely to get favorable outcomes.

Stability of neodymium:YAG laser posterior capsulotomy in eyes with capsular tension rings

·AIM: To evaluate the stability of neodymium(Nd):YAG laser posterior capsulotomy in eyes with capsular tension rings(CTRs).·METHODS: A total of 60 eyes that underwent cataract surgery and laser posterior capsulotomy postoperatively were included in this retrospective cohort study. To evaluate the safety and stability of capsulotomy, changes in the size of posterior capsulotomy and anterior chamber depth(ACD) in three groups: the group without CTR, the group with 12 mm CTRs, and the group with 13 mm CTRs, at 1wk, 3, 12, and 15mo after capsulotomy, were compared. ·RESULTS: In the group without CTR and the group with 12 mm CTR, there was no significant change in ACD at every post-laser follow-up. In the group with 13 mm CTR, the ACD change was significant until 3mo after capsulotomy. In all groups, there was a significant increase in the area of capsulotomy between 1wk and 3mo post-laser. Between 3 and 12mo post-laser, only the group with 13 mm CTR showed a significant increase in the area of capsulotomy(P<0.01). ·CONCLUSION: Laser posterior capsulotomy is safe in all three groups. The capsulotomy and ACD become stabilized and have not shown significant changes since 1y postlaser, even with larger CTRs. The maintenance of centrifugal capsular tension can last longer with larger CTRs, and the stability of the capsulotomy site can be reached about 12mo after capsulotomy in pseudophakic eyes with larger CTRs.

Efficacy and Safety of Alexandrite and Nd:YAG Laser Combination in Permanent Hair Removal

Background and Objective: Unwanted hair growth is a discomforting issue affecting both genders. People have tried various methods to get rid of this situation. This study aims to evaluate the efficacy and safety of a combined Alexandrite and Nd:YAG laser treatment for permanent hair removal, drawing insights from existing literature. Materials and Methods:This study included a total of 2127 patients (302 males, 1825 females) aged 18 - 65, with complete data, who underwent hair removal treatment between December 2018 and April 2021. These patients were treated using the Duetta laser system (Quanta system, Samarate, Italy), combining Alexandrite 755 nm and Nd:YAG 1064 nm wavelengths. The patients’ skin types were classified according to the Fitzpatrick classification scale. Target area/areas for laser hair removal was/were determined. Laser parameters, pulse counts, pain levels assessed through the Visual Pain Scale (VPS), and patient satisfaction were documented based on skin types. Findings: Across various skin types, Types I - II exhibited the highest treatment success rates (87%), with the axillary region achieving the highest rate (83%) and the face region achieving the lowest rate (75%). Pain scale analysis indicated that 98% of patients tolerated the procedure well. Patient satisfaction levels exceeded 90%. Evaluation of complication rates revealed minimal occurrences. Conclusion: The combined Alexandrite and Nd:YAG laser system demonstrates both efficacy and safety across diverse skin types, attributed to its notable success rates, minimal adverse effects, and high patient tolerance.

YAG laser welding with surface activating flux

YAG laser welding with surface activating flux has been investigated, and the influencing factors and mechanism are discussed. The results show that both surface activating flux and surface active element S have fantastic effects on the YAG laser weld shape, that is to obviously increase the weld penetration and D/W ratio in various welding conditions. The mechanism is thought to be the change of weld pool surface tension temperature coefficient, thus, the change of fluid flow pattern in weld pool due to the flux.

A new technique for Nd:YAG laser posterior capsulotomy

AIM:To investigate the effects of a new opening pattern in neodymium:yttrium-aluminum-garnet(Nd:YAG)laser posterior capsulotomy on visual function.METHODS:This technique was conducted along a circular pattern.The energy ranged between 0.8 and1.2 mJ/pulse was consumed and mean total energy levels were 74±21 mJ(mean±standard deviation:SD,from 40 to167)and laser shots aimed at 150μm away behind a datum point and went along an imaginary line which extends 0.5 mm inside from optic margin and into the circular en bloc pattern.Vitreous stands were attached with fragment and then they were cut off by the laser after circular application.The circular fragment was completely separated from vitreous,and then this fragment was quickly sunk in intravitreal space.RESULTS:The follow-up period ranges from at least a week to 40mo,making 15.8mo on average.The procedural outcome showed 96%(74 eyes out of the 77eyes)enhancement in patients’visual acuity.Cystoid macular edema or retinal detachment was not observed in any of the patients during follow-up periods.CONCLUSION:This new technique is expected to improve the weaknesses that the conventional procedures have by adding the process to cut off vitreous stands attached with the fragment by the laser to the circular application.

Pulsed Nd:YAG laser cladding of high silicon content coating on low silicon steel

A pulsed Nd：YAG （yttrium aluminum garnet） laser-based technique was employed to clad low silicon steel with preplaced Si and Fe mixed powders for high Si content. The surface morphology, microstructural evolution, phase composition, and Si distribution, within the obtained cladding coatings, were characterized by optical microscopy （OM）, field emission scanning electron microscopy （FE-SEM）, with associated energy dispersive spectroscopy （EDS）, transmission electron microscopy （TEM）, and X-ray diffraction （XRD）. The microhardness was also measured along the depth direction of the specimens, A crack- and pore-free cladding coating through excellent metallurgical bonding with the substrate was successfully prepared on low silicon steel by means of optimized single-track and multi-track laser cladding. The phases of the coating are a-Fe, T-Fe, and FeSi. The high microhardness of the lasercladding zone is considered as an increase in Si content and as the refined microstructure produced by the laser treatment. The Si contents of the cladding coatings were about 5.8wt% in the single-track cladding and 6.5wt% in the multi-track cladding, respectively.

Ureteroscopic Holmium:YAG Laser Lithotripsy for Managing Ureteral Calculi (A Report of 168 Cases)

Summary: The effectiveness and safety of ureteroscopic holmium:YAG laser lithotripsy for managing ureteral calculi was evaluated. Ureteroscopic holmium:YAG laser lithotripsy was performed in 168 ureteral calculi (upper 27 cases, middle 33 cases and lower 108 cases). The results showed that the stone-free rate was 92.6 % in the upper ureteral calculi, 93.9 % in the middle ureteral calculi and 94.4 % in the lower ureteral calculi, respectively. The complication rate was 4.8 % (8 cases). It was suggested that ureteroscopic holmium:YAG laser lithotripsy is a highly effective and safe treatment modality for managing ureteral calculi.

Effects of 946-nm thermal shift and broadening on Nd^(3+):YAG laser performance

Spectroscopic properties of flashlamp pumped Nd^3＋：YAG laser are studied as a function of temperature in a range from-30℃ to 60℃. The spectral width and shift of quasi three-level 946.0-nm inter-Stark emission within the respective intermanifold transitions of ^4F3/2→^4I9/2are investigated. The 946.0-nm line shifts toward the shorter wavelength and broadens. In addition, the threshold power and slope efficiency of the 946.0-nm laser line are quantified with temperature.The lower the temperature, the lower the threshold power is and the higher the slope efficiency of the 946.0-nm laser line is,thus the higher the laser output is. This phenomenon is attributed to the ion-phonon interaction and the thermal population in the ground state.

Comparison of laser iridotomy using short duration532-nm Nd: YAG laser (PASCAL) vs conventional laser in dark irides

AIM: To evaluate the outcome of laser iridotomy using532-nm Nd: YAG laser(PASCAL) with short pulse duration and Nd: YAG laser compared to conventional combined laser iridotomy.METHODS: Retrospective, nonrandomized, comparative case series. Forty-five eyes of 34 patients underwent laser iridotomy. Twenty-two eyes underwent iridotomy using short duration PASCAL and Nd: YAG laser, and 23 eyes underwent iridotomy using conventional combined laser method. The average settings of PASCAL were60 μm and 700-900 m W with a short duration of 0.01 s to reduce the total applied energy. The conventional laser was 50 μm and 700-900 m W for 0.1s. After photocoagulation with these laser, the Nd: YAG laser was added in each group. Endothelial cell counts of preiridotomy and 2mo after iridotomy were measured and compared.RESULTS: All eyes completed iridotomy successfully.The total energy used in the PASCAL group was 1.85 ±1.17 J. Compared to conventional laser 13.25 ±1.67 J, the energy used was very small due to the short exposure time of PASCAL. Endothelial cell counts were reduced by0.88% in the PASCAL group and 6.72% in the conventional laser group(P =0.044). The change in corneal endothelial cell counts before and after iridotomy was significant in conventional combined laser iridotomy group(P =0.004).CONCLUSION: Combined PASCAL and Nd:YAG laseriridotomy is an effective and safe technique in the dark brown irides of Asians. Furthermore, the short duration of exposure in PASCAL offers the advantages of reducing the total energy used and minimizing the corneal damage.

Treatment effects and periodontal status of chronic periodontitis after routine Er:YAG laser-assisted therapy

BACKGROUND Routine preclinical interventions for patients with chronic periodontitis such as supragingival cleaning and subgingival curettage,establishing a balanced occlusal relationship,and irrigation with 3%hydrogen peroxide can relieve the symptoms to some extent.However,there is room for improvement in the overall effect.For example,Er:YAG lasers can quickly increase the temperature of the irradiated tissue,effectively eliminate dental plaque and calculus,reduce periodontal pockets,adjust periodontal microecology,and reduce the gingival sulcus.The content of factors in the liquid,and then achieve the purpose of treatment.AIM The aim was evaluate the effect of Er:YAG laser-assisted routine therapy on the periodontal status in chronic periodontitis.METHODS Between October 2018 and January 2020,106 patients with chronic periodontitis in our hospital were randomly assigned to either the study or control group,with 53 patients in each group.The control group underwent routine therapy,and the study group underwent Er:YAG laser therapy in addition to routine therapy.We evaluated the treatment outcome in both groups.Periodontal status was determined by clinical attachment loss(CAL),gingival index(GI),periodontal probing depth(PD),dental plaque index(PLI),and sulcular bleeding index(SBI),inflammatory factors in the gingival crevicular fluid,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-8],and colony forming units(CFUs).RESULTS Total effectiveness in the study group(94.34%)was higher than that in the control group(79.25%,P<0.05).The clinical parameters in the study group(PD,5.28±1.08 mm;CAL,4.81±0.79 mm;SBI,3.37±0.59;GI,1.38±0.40;PLI,2.05±0.65)were not significantly different from those in the control group(PD,5.51±1.14 mm;CAL,5.09±0.83 mm;SBI,3.51±0.62;GI,(1.41±0.37;PLI,1.98±0.70)before treatment(P>0.05).However,after treatment,the parameters in the study group(PD,2.97±0.38 mm;CAL,2.71±0.64 mm;SBI,2.07±0.32;GI,0.51±0.11;PLI,1.29±0.34)were lower than those in the control group(PD,3.71±0.42 mm;CAL,3.60±0.71 mm;SBI,2.80±0.44;GI,0.78±0.23;PLI,1.70±0.51)(P<0.05).Differences in crevicular TNF-α,IL-6,and IL-8 levels in the study(TNF-α,7.82±3.43 ng/mL;IL-6,11.67±2.59 ng/mL;IL-8,12.12±3.19 pg/mL)and control groups(TNF-α,9.06±3.89 ng/ml,IL-6,12.13±2.97 ng/mL,IL-8,10.99±3.30 pg/mL)before therapy(P>0.05)were not significant.Following treatment,the parameters were significantly lower in the study group(TNF-α,2.04±0.89 ng/mL;IL-6,4.60±1.26 ng/mL;IL-8,3.15±1.08 pg/mL)than in the control group(TNF-α,3.11±1.07 ng/mL;IL-6,6.25±1.41 ng/mL;IL-8,4.64±1.23 pg/mL,P<0.05).The difference in the CFU of the study group[(367.91±74.32)×104/mL and control group(371.09±80.25)×104/mL]before therapy was not significant(P>0.05).The CFU decreased in both groups following therapy,however,the CFU values were lower in the study group[(36.09±15.26)×104/mL]than in the control group[(45.89±18.08)×104/mL](P<0.05).CONCLUSION Combining Er:YAG lasers with routine measures significantly improved the overall periodontal therapy outcomes by improving periodontal status and reducing oral levels of inflammatory factors and CFUs.

Passively Q-Switched Nd,Cr:YAG Laser Simultaneous Dual-Wavelength Operation at 946 nm and 1.3μm

A diode-end-pumped Q-switched high-efficiency Nd, Cr：YAG laser with simultaneous dual-wavelength emission at 946nm and 1.3μm is demonstrated. The maximum output power of 1.93 W with simultaneous dual-wavelength operation is achieved at an absorbed pump power of 13.32 W and an absorbed slope efficiency of 15.15%. The maximum optical-optical efficiency is 14.49% with pulse widths of 16.38ns at 946nm and 26.65ns at 1.3μm. A maximum total repetition rate of 43.25 kHz is obtained.

Treatment of Special Renal Colic with Ureteroscope and Holmium YAG Laser

Objective To investigate the method of emergent relief of special renal colic and treatment of ureter diseases causing renal colic. Methods By analyzing 63 cases of special renal colic treated with ureteroscope and Holmium YAG laser. Results 61 cases of renal colic were relieved in a short period of time and the original ureter diseases causing renal colic were cured. Conclusion Special renal colic could be treated with ureteroscope and Holmium YAG laser in a quick and effective manner.

PRESS FORMABILITY OF YAG LASER WELDED TRIP STEEL SHEETS

The effects of YAG laser welding conditions on mechanical properties andpress formability (bendability, stretch-formability and deep drawability) of high-strengthtransformation-induced plasticity-aided dual-phase (TDP) steel were investigated. Tensile tests andpress forming tests have been conducted for laser butt welded joints between two pieces of the samesteel. The tensile property and press formability were affected by the welding speed of 100 to1100mm/min and the energy of 6 to 9J/pulse. Excellent press formability was obtained with the energyof 6J/pulse and the welding speed of 300mm/min. It was concluded that the excellent weldability ofthe TDP steel can be ascribed to the weld joint formation.

Effects of output waveforms on penetration for Nd :YAG laser welding

By using a Nd: YAG laser welding system devised for transmitting continuous, rectangular and pulsed waveforms, comprehensive and deep investigation is focused on the effects of several parameters of rectangular waveform and pulsed output wave superimposed on a rectangular waveform on the penetration depth of weld. Research results indicate that the average power, duty cycle, frequency and peak power of rectangular wave affect the weld penetration depth to different extent. Results of experiments and analysis also indicate that the pulse delay time, pulse width and the power ratio of pulse to rectangular waveform seriously influence the penetration when the pulsed wave is superimposed on a rectangular waveform.

Cutting of nonmetallic materials using Nd:YAG laser beam

This study deals with Nd：YAG laser cutting nonmetallic materials, which is one of the most important and popular industrial applications of laser. The main theme is to evaluate the effects of Nd：YAG laser beam power besides work piece scanning speed. For approximate cutting depth, a theoretical study is conducted in terms of material property and cutting speed. Results show a nonlinear relation between the cutting depth and input energy. There is no significant effect of speed on cutting depth with the speed being larger than 30 mm/s. An extra energy is utilized in the deep cutting. It is inferred that as the laser power increases, cutting depth increases. The experimental outcomes are in good agreement with theoretical results. This analysis will provide a guideline for laser-based industry to select a suitable laser for cutting, scribing, trimming, engraving, and marking nonmetallic materials.

High-Power Passively Q-Switched Nd:YAG Laser at 1112 nm with a Cr^(4+):YAG Saturable Absorber

A high-power passively Q-switched Nd：YAG laser operating at lll2nm with Cr4＋：yAO as a saturable absorber is demonstrated. Under 808 nm diode-direct pumping, the maximum average output power of 2.73 W is achieved at the pump power of 16.65 W, corresponding to an optical-to-optical conversion efficiency of 16.4%. At the same time, the pulse width, pulse repetition rate, single pulse energy and peak power are 27.2ns, 9 kHz, 303.3#3 and 11.2kW, respectively. As far as we know, the result gives the highest average output power at 1112nm generated by an 808 nm diode-end-pumped Nd：YAG laser.

Surface modifications of biometallic commercially pure Ti and Ti–13Nb–13Zr alloy by picosecond Nd:YAG laser

The effects of picosecond Nd:YAG laser irradiation on chemical and morphological surface characteristics of the commercially pure titanium and Ti–13Nb–13Zr alloy in air and argon atmospheres were studied under different laser output energy values.During the interaction of laser irradiation with the investigated materials,a part of the energy was absorbed on the target surface,influencing surface modifications.Laser beam interaction with the target surface resulted in various morphological alterations,resulting in crater formation and the presence of microcracks and hydrodynamic structures.Moreover,different chemical changes were induced on the target materials’surfaces,resulting in the titanium oxide formation in the irradiation-affected area and consequently increasing the irradiation energy absorption.Given the high energy absorption at the site of interaction,the dimensions of the surface damaged area increased.Consequently,surface roughness increased.The appearance of surface oxides also led to the increased material hardness in the surface-modified area.Observed chemical and morphological changes were pronounced after laser irradiation of the Ti–13Nb–13Zr alloy surface.

Experimental study of electro-optical-switched pulsed Nd:YAG laser

We report the specification of a compact and stable side diode-pumped Q-switched pulsed Nd：YAG laser. We ex- perimentally study and compare the performance of the pulsed Nd：YAG laser in the free-running and Q-switched modes at different pulse repetition rates from 1 Hz to 100 Hz. The laser output energy is stabilized by using a special configu- ration of the optical resonator. In this laser, an unsymmetrical concave-concave resonator is used and this structure helps the mode volume to be nearly fixed when the pulse repetition rate is increased. According to the experimental results in the Q-switched operation, the laser output energy is nearly constant around 70 mJ with an FWHM pulse width of 7 ns at 100 Hz. The optical-to-optical conversion efficiency in the Q-switched regime is 17.5%.

Controlled Laser Transformation Hardening of Martensitic Stainless Steel by Pulsed Nd:YAG Laser

Laser transformation hardening （LTH） was applied to the surface of the AISI 420 martensitic stainless steel by a pulsed Nd：YAG laser to obtain optimum hardness. The influences of process parameters （laser pulse energy, duration time, and travel speed） on the depth and hardness of laser treated area were investigated. Image analysis of SEM microstructure of AISI 420 showed that plate-like carbide have almost fully and （30-40）% of globular carbide particles dissolved into the matrix after laser transformation hardening by pulsed laser and the microstructure was refined to obtain controlled tempered martensite microstructure with 450 VHN hardness.