Related Experiment Video
Updated: Oct 7, 2025
Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser
Published on: May 9, 2018
Retrograde intrarenal surgery: laser showdown (Ho:YAG vs thulium fiber laser)
Mariela Corrales1, Olivier Traxer
1Sorbonne University GRC Urolithiasis no. 20-Tenon Hospital, Paris, France.
Purpose Of Review:
Retrograde intrarenal surgery (RIRS) has always been recommended for large stones > 20 mm, using the Ho:YAG laser. The introduction of a new technology in the urological market, the thulium fiber laser (TFL) has revolutionized the endourology world because of its characteristics and significantly shorter laser-on time (LOT) and operative time, without scarifying the champ vision. The aim of this review is to evaluate the most relevant findings of the last 2 years of each laser technology, confronting Ho:YAG vs TFL, analyzing who is more suitable for performing an efficient RIRS.
Recent Findings:
Five full clinical trials using TFL for RIRS were found. Median LOT was between 2.8 and 34 min. All stones were similar in terms of stone volume, >500 mm3, and stone density, > 800 HU. Low complication rate, mostly Clavien-Dindo grade I and II and not related to the laser itself. One clinical trial only analyzed the efficacy of TFL for > 20 mm renal stones.
Summary:
Based on this review, TFL performs a more efficient RIRS than the Ho:YAG laser with similar safety.
