{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T18:31:59Z","timestamp":1786559519824,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the fracture mechanism of impacted ureteral stones during laser lithotripsy (LL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Impacted 6\u2009\u00d7\u20096\u2009mm cylindrical BegoStone samples embedded in a hydrogel ureter model and a 100% calcium phosphate (CaP) stone (58\u2009\u00d7 60\u2009mm) were treated in saline using holmium:YAG (Ho:YAG) laser or thulium fiber laser (TFL) via three clinical strategies: \u201cdrill and core,\u201d contact, and near\u2010contact modes. Laser pulses were delivered at 0.8\u2009J\/12\u2009Hz, 1.0\u2009J\/10\u2009Hz, and 1.2\u2009J\/8\u2009Hz with a 3\u2009s on\/3\u2009s off protocol under continuous irrigation (40\u2009mL\/min). Crater formation, surface crack development, and bubble dynamics were assessed via optical coherence tomography, ureteroscope video, high\u2010speed photography, and hydrophone measurements. To delineate the contributions of different plausible damage mechanisms, bubble collapse was suppressed using the ureteroscope's proximity effect, and photothermal ablation was minimized by treating donut\u2010shaped BegoStones with central tunnels. The role of bubble expansion in stone fracture was evaluated by varying either tunnel size or pulse energy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Surface cracks and stone fractures occurred only in Ho:YAG\u2010treated BegoStone and CaP stone samples under the \u201cdrill and core\u201d strategy. TFL produced deeper craters yet failed to induce significant cracks under any test conditions. Although Ho:YAG\u2010induced bubble collapses generated stronger acoustic emissions than TFL, suppression of bubble collapse or photothermal ablation had minimal impact on crack growth beyond localized surface damage. Instead, the number and length of surface cracks correlated strongly with the maximum bubble lateral diameter and expansion rate \u2013 both substantially greater for Ho:YAG laser than TFL. Crack formation also correlated inversely with the initial crater or tunnel size. These observations have significant clinical implications for optimizing stone fragmenting in LL procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Intra\u2010crater bubble expansion, rather than photothermal ablation or bubble collapse, is the primary mechanism driving the fracture of impacted ureteral stones in LL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lsm.70151","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T17:21:57Z","timestamp":1779816117000},"page":"575-591","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intra\u2010Crater Bubble Expansion Drives the Fracture of Impacted Ureteral Artificial and Human Calcium Phosphate Stones in Laser Lithotripsy"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2653-1814","authenticated-orcid":false,"given":"Junqin","family":"Chen","sequence":"first","affiliation":[{"name":"Thomas Lord Department of Mechanical Engineering and Materials Science Duke University Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2368-6151","authenticated-orcid":false,"given":"Pei","family":"Zhong","sequence":"additional","affiliation":[{"name":"Thomas Lord Department of Mechanical Engineering and Materials Science Duke University Durham North Carolina 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