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Ho: YaG laser lithotripsy: recent innovations.

Benedikt Becker¹, Andreas J Gross, Christopher Netsch

¹Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany.

Current Opinion in Urology

|November 9, 2018

Summary

Recent innovations in holmium laser lithotripsy enhance urinary stone treatment. Newer holmium:yttrium-aluminium-garnet (Ho:YAG) lasers offer improved stone fragmentation and dusting, with novel features like Moses mode reducing retropulsion.

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Area of Science:

Urology
Laser Technology
Nephrolithiasis Treatment

Background:

Holmium:yttrium-aluminium-garnet (Ho:YAG) laser lithotripsy is a recognized, effective treatment for urinary calculi.
Technological advancements have refined Ho:YAG laser capabilities, allowing for precise control over fragmentation and dusting techniques.

Purpose of the Study:

To review and summarize recent innovations in holmium laser technology specifically for lithotripsy.
To discuss the impact of these advancements on the efficacy and application of Ho:YAG laser lithotripsy.

Main Methods:

Systematic review of recent pivotal publications on holmium laser innovations in lithotripsy.
Discussion of technological developments and their clinical implications.

Main Results:

Ho:YAG lithotripsy demonstrates high tolerability and efficiency in treating urinary stones.
Newer holmium laser generations allow adjustable pulse parameters for tailored stone ablation (fragmentation vs. dusting).
The 'Moses mode' has shown reduced stone retropulsion and increased ablation rates in in-vitro studies due to improved energy transmission.

Conclusions:

Ho:YAG laser lithotripsy is increasingly efficient, offering better control over retropulsion and stone volume reduction.
Emerging technologies, such as thulium fiber lasers, show promise as potential future alternatives to Ho:YAG lasers for lithotripsy.