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Lasers for stone treatment: how safe are they?
Yasser A Noureldin1,2, Panagiotis Kallidonis1, Evangelos N Liatsikos1,3
1Department of Urology, University Hospital of Patras, Patra, Greece.
Current Opinion in Urology
|January 3, 2020
Summary
Advancements in laser lithotripsy include new holmium:yttrium-aluminum-garnet (Ho:YAG) lasers with Moses technology for improved stone removal and the emerging thulium fiber laser (TFL). Laser safety remains crucial.
Area of Science:
- Urology
- Endourology
- Laser technology
Background:
- Urolithiasis prevalence and scope miniaturization drive laser lithotripsy innovation.
- The holmium:yttrium-aluminum-garnet (Ho:YAG) laser is a long-established tool in endourology.
- Laser lithotripsy technology is evolving with new laser types and features.
Purpose of the Study:
- To review recent advancements in laser lithotripsy technologies.
- To update knowledge on new laser types and their applications.
- To discuss current laser safety concerns in lithotripsy procedures.
Main Methods:
- Review of experimental studies on new laser lithotripsy technologies.
- Analysis of holmium:yttrium-aluminum-garnet (Ho:YAG) laser parameters and performance.
- Evaluation of thulium fiber laser (TFL) characteristics and potential.
Main Results:
- Ho:YAG laser lithotripsy is the current standard, with Moses technology enhancing stone ablation and reducing retropulsion.
- Thulium fiber laser (TFL) shows promise due to its small fiber size, low pulse energy, and high frequency.
- Further clinical and experimental studies are needed to validate these emerging technologies.
Conclusions:
- Ho:YAG lasers with Moses technology offer improved efficiency and stone control.
- Thulium fiber laser (TFL) may become a competitive alternative to Ho:YAG lasers.
- Adherence to laser safety protocols is essential during lithotripsy to prevent adverse events.
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