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In Vitro evaluation of laser-stone interaction.

M L Letouche^1,2,3,4, S Kutchukian^1,2,4,5, M Corrales^1,2,6,7

¹Sorbonne Université, GRC20-Endolase LAB, APHP, Hopital Tenon, Paris, 75020, France.

|July 11, 2026

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Thulium Fiber Laser (TFL) and Holmium: YAG (Ho: YAG) lasers were compared for urinary stone fragmentation. TFL showed greater stone cratering and higher temperatures, suggesting thermal effects are key in laser lithotripsy outcomes.

Area of Science:

Urology
Laser Physics
Biomedical Engineering

Background:

Laser lithotripsy is a primary treatment for urinary stones.
Holmium: YAG (Ho: YAG) and Thulium Fiber Laser (TFL) are commonly used.
Determinants of laser lithotripsy efficacy and safety require further elucidation.

Purpose of the Study:

To investigate in vitro laser-stone interactions between TFL and Ho: YAG lasers.
To understand factors influencing stone fragmentation during laser lithotripsy.

Main Methods:

Tested TFL and Ho: YAG lasers with 270 μm fibers on synthetic stones.
Evaluated four conditions: dry, wet, immersed in contact, and at 2 mm distance.
Assessed crater dimensions, carbonization, and temperature profiles using microscopy and thermocouples.

Keywords:

Interaction Laser Lithiasis Lithotripsy Stone

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Main Results:

Crater radius increased with pulse energy for both lasers.
Thulium Fiber Laser (TFL) produced significantly larger craters than Ho: YAG.
TFL exhibited higher maximum contact temperatures, particularly in dry and contact conditions.

Conclusions:

Thermal effects significantly influence laser-stone interactions in lithotripsy.
Thulium Fiber Laser (TFL) demonstrates potentially greater stone ablation efficiency.
Further research, including modeling, is needed to optimize laser lithotripsy clinical outcomes.