Endoscopic lithotripsy and the FREDDY laser: initial experience

Area of Science:

• Urology
• Laser Technology
• Endourology

Background:

• The frequency-doubled double-pulse neodymium:YAG (FREDDY) laser is a novel device for endoscopic lithotripsy.
• It combines features of solid and dye lasers, utilizing a flexible optical fiber for ureterorenoscopy.
• The FREDDY laser offers a potentially more affordable and lower-maintenance alternative to existing laser systems.

Purpose of the Study:

• To evaluate the efficacy and role of the FREDDY laser in ureteroscopic treatment of urinary stones.
• To assess its performance in a clinical setting for various stone types and locations.

Main Methods:

• A FREDDY laser was used to treat 29 stones in 26 patients.
• Stones treated included renal (13) and ureteral (16), with a mean size of 9 mm.
• Treatment success was defined as the absence of residual fragments on 3-month postoperative radiography.

Main Results:

• Satisfactory results were achieved for 26 stones, with 69% of patients stone-free within 3 months.
• Complete treatment was achieved for 72.4% of stones; however, 8 patients had residual fragments, particularly those larger than 10 mm.
• Fragmentation was ineffective for 2 cystine stones and poor for one calcium oxalate monohydrate stone. Average hospitalization was 1.5 days.

Conclusions:

• Endoscopic FREDDY laser lithotripsy is effective and safe for urinary stones due to its wavelengths.
• Its moderate cost and compatibility with flexible ureterorenoscopy make it a viable therapeutic option.
• Limitations include reduced efficacy for cystine stones and inability to treat tissue lesions.