Recent advances in infrared laser lithotripsy [Invited]

Area of Science:

• Medical Engineering
• Laser Physics
• Urology

Background:

• The holmium:YAG laser (2120 nm) is the established clinical standard for laser lithotripsy.
• Despite its efficacy in ablating all urinary stone types, it possesses inherent limitations.

Purpose of the Study:

• To review alternative mid-infrared (mid-IR) laser technologies for lithotripsy.
• To evaluate their capabilities and limitations in the context of developing an ideal laser lithotripsy system.

Main Methods:

• Review of existing literature on mid-IR laser systems used in lithotripsy.
• Comparative analysis of holmium:YAG, thulium fiber, thulium:YAG, and erbium:YAG lasers.

Main Results:

• Holmium:YAG lasers are effective but have fundamental limitations for stone ablation.
• Thulium fiber (1908, 1940 nm), thulium:YAG (2010 nm), and erbium:YAG (2940 nm) lasers have been explored as alternatives.
• Each alternative laser technology presents a unique profile of capabilities and limitations.

Conclusions:

• The quest for an ideal laser lithotripsy system necessitates understanding the trade-offs of various mid-IR laser technologies.
• Further research into alternative lasers may lead to safer and more efficient urinary stone ablation.