[Retrograde intrarenal surgery using a 1.94 m superpulsed thulium fiber laser]

Area of Science:

• Urology
• Laser Medicine
• Nephrology

Background:

• Surgical treatment of urinary stone disease is a key urological practice.
• Holmium fiber laser (Ho:YAG) is currently the primary tool for stone fragmentation.
• Emerging thulium fiber laser technology shows promise for improved stone treatment.

Purpose of the Study:

• To evaluate the performance of a 1.94 μm superpulsed thulium fiber laser in retrograde intrarenal surgery (RIRS).
• To optimize laser settings for enhanced stone dusting and surgical outcomes.

Main Methods:

• A study included 152 patients with renal stones treated between February 2018 and July 2019.
• Analysis focused on laser settings, retropulsion, visibility, and stone-free rates during RIRS.
• Settings evaluated included varying pulse energy, frequency, and power output.

Main Results:

• The superpulsed thulium fiber laser (1.94 μm, 40 W max power, 500 W peak power) demonstrated high clinical efficiency.
• Effective stone dusting was achieved with good endoscopic imaging and minimal retropulsion.
• High stone-free rates were observed on the first postoperative day.

Conclusions:

• The 1.94 μm superpulsed thulium fiber laser is highly effective for RIRS in treating urinary stones.
• Optimizing thulium fiber laser settings can significantly improve surgical outcomes and stone-free rates.