The changing role of lasers in urologic surgery

To summarize recent publications on the topic of laser in urology and explore new developments which may impact the future role of lasers in surgery.

Ho: Yttrium-aluminium garnet (YAG) laser with Moses technology allows less retropulsion during a lithotripsy, yet its efficacy needs to be tested in clinical trials. Data on the efficacy of this device for benign prostatic obstruction treatment is also pending. A new promising generation of laser systems - thulium-fiber (Tm-fiber) lasers - has been introduced. Tm-fiber has already been shown to be effective and well tolerated in endoscopic enucleation of the prostate and has demonstrated favorable outcome compared with Ho:YAG in preclinical lithotripsy studies. However, more studies are needed to better understand the use of this novel technology and elucidate its role within the armamentarium of available technologies.

Lasers remain an integral part of benign prostatic hyperplasia surgery and stone treatment and gain popularity in en-bloc resection of bladder cancer. Current efficacy of laser systems in prostate cancer ablation and their place in laparoscopy remain unclear, despite promising initial reports.