Durability of reusable holmium: YAG laser fibers: A multicenter study

Purpose Single use and reusable variants of holmium:YAG laser fibers are available to treat calculi during ureteroscopic procedures. In this prospective, multicenter study we evaluated a series of reusable holmium:YAG laser optical fibers. We hypothesized that reusable fibers provide a cost advantage over single use variants. Materials and Methods We prospectively recorded fiber data, including type, size, number of uses, laser pulse energy and frequency, and total energy delivered. All fibers were new and purchased off the shelf by staff at each institution. We performed a cost analysis comparing reusable fibers to single use variants. Results During 541 procedures a total of 37 holmium:YAG optical laser fibers were used, including 21 Laser Peripherals 270 (Laser Peripherals, Golden Valley, Minnesota), 7 Laser Peripherals 365, 4 Lumenis SlimLine™ 200 and 3 Lumenis SlimLine 365 fibers. After stratifying by core size 365 μm core fibers had significantly more uses than 270 μm core fibers (average 23.5 vs 11.3, p <0.02). By fiber type the mean ± SE number of uses was 12.8 ± 2.44, 3 ± 0.4, 21.3 ± 7.12 and 28.7 ± 6.69 for the Laser Peripheral 270, Lumenis SlimLine 200, Laser Peripherals 365 and Lumenis SlimLine 365, respectively. The total cost savings for reusable fibers vs single use variants was $64,125. Conclusions Reusable holmium:YAG optical laser fibers are a more cost-effective option than single use variants. Fibers with a 365 μm core provide more uses than smaller 270 μm variants.