Optimization of Thulium Fiber Laser Lithotripsy Efficacy Based on Multidimensional Parameter Combination Strategies

Area of Science:

• Urology
• Laser Physics
• Biomedical Engineering

Background:

• Urinary stone lithotripsy efficacy is influenced by thulium fiber laser (TFL) parameters.
• Previous research has not systematically evaluated the impact of TFL parameter combinations on lithotripsy outcomes.

Purpose of the Study:

• To systematically evaluate how peak power (Ppeak), average power (AP), and pulse energy (Ep) combinations in TFLs affect urinary stone lithotripsy.
• To understand the influence of these parameters on fragmentation efficiency, dusting efficiency, thermal effects, and stone retropulsion.

Main Methods:

• A multiparameter decoupling experimental platform was utilized to systematically vary Ppeak, AP, and Ep.
• Statistical analysis included independent-samples t-tests and two-way ANOVA to assess parameter effects.
• Experiments were repeated at least three times to ensure reliability.

Main Results:

• Increasing Ppeak significantly enhanced fragmentation and dusting efficiency at lower AP and Ep, with minimal impact on thermal effects.
• Higher AP attenuated the benefits of increased Ppeak on fragmentation and dusting.
• Stone retropulsion was not significantly increased even with higher Ppeak under specific conditions.

Conclusions:

• Optimizing TFL parameters, specifically higher Ppeak with lower AP and Ep, can improve lithotripsy efficiency and minimize thermal damage.
• Conversely, lower Ppeak with higher AP and Ep can reduce stone retropulsion while maintaining efficacy.
• The study provides a framework for future clinical research into precise, personalized urinary stone treatment.