[Experimental verification of thulium lithotripsy].

Area of Science:

• Urology
• Laser Physics
• Biomedical Engineering

Background:

• Minimally invasive surgery, including retrograde intrarenal surgery, is increasingly used for urolithiasis management.
• Holmium: YAG (Ho: YAG) lasers at 2.1 μm are the current standard for laser lithotripsy.
• Thulium (Tm) fiber lasers at 1.94 μm offer higher water absorption, suggesting potential for improved stone fragmentation.

Purpose of the Study:

• To experimentally evaluate the efficacy and safety of a novel pulsed thulium fiber laser (1.94 μm) for lithotripsy.
• To compare the performance of the thulium fiber laser against a standard holmium laser (2.1 μm).

Main Methods:

• Comparison of ex-vivo lithotripsy using a thulium fiber laser (1.94 μm, 500 W peak power) and a holmium laser (2.1 μm, 100-120 W average power).
• Analysis of physical principles of laser-tissue interaction and stone fragmentation mechanisms for both laser types.

Main Results:

• The thulium fiber laser demonstrated advantages in stone fragmentation compared to the holmium laser in urological practice.
• Specific advantages of the 1.94 μm thulium fiber laser over the 2.1 μm holmium laser were observed in experimental settings.

Conclusions:

• The thulium fiber laser (1.94 μm, 500 W peak power) provides a highly effective and safe option for lithotripsy.
• The higher water absorption of Tm: fiber laser radiation may contribute to enhanced stone-crushing efficiency and reduced procedure times.