15/02/2026
This is Prometheus. It's designed for braking up large urinary stones found in the ureter and bladder. Such stones typically eat laser fibers for lunch, meaning the efficiency of the surgery falls off rapidly because the fiber tips get damaged rapidly. Most folks attribute this damage to flying stone fragments. I am not so sure that's right, but if it is, this fiber will last a lot longer than the ones used today.
Normal fiber tips are 'cleaved'-- they are scored and snap cut, leaving a sharp edge and relatively flat surface. Both are easily chipped by flying stone debris. These tips are also usually 0.6 mm in diameter, although some are as large as 1 mm but the bigger fibers cost a boat load of money. (I know, I make some of them.)
Prometheus tips are 1.2 mm in diameter but the fiber is only 0.6 mm, so right there we have the robustness of the largest fiber available -- plus some -- at the cost of the smaller fiber. That won't matter if it's toast in 5 minutes like regular fibers, though, so I made it with a focusing lens that allows working a few millimeters away from the stone. The round profile adds to the resistance against damage from fragments, too, deflecting some and eliminating any sharp edges that are easily chipped.
I think it's going to be a winner for large stones, particularly coupled with our new thulium laser. We did a stone case with the laser the other day -- a 4 cm diameter staghorn stone -- and finished in 45 minutes with a regular 0.6 mm fiber. Thulium lasers don't usually do very well with large stones...this one did as well as a holmium.