Mini-PCNL using the new Cyber Ho with Magneto technology versus thulium fiber laser: are there any differences?

To assess differences in safety and efficacy between Holmium: YAG Cyber Ho generator with Magneto pulse modulation technology (Quanta System^®) and Thulium Fiber Laser (TFL) in mini-percutaneous nephrolithotripsy (Mini-PCNL) of 10-20 mm renal stones.

Patients underwent supine Mini-PCNL using TFL Fiber Dust generator (Group A) versus Cyber Ho generator with Magneto technology (Group B). 18 Fr access sheath after pneumatic dilatation, 12 Fr nephroscope and 550 μm laser fiber were used in all cases. Energy and frequency settings were tailored to stone features. Intraoperative parameters, stone-free rate (SFR) and complications were assessed.

50 patients were treated in each group. Preoperative features were comparable. Mean stone diameter was 16.6 vs. 17.8 mm in Group A vs. B (p = 0.18). Mean total operative time (45.5 vs. 42.4 min) and lasing time (11.2 vs. 9.9 min) were similar. In the Magneto group mean delivered energy (8.4 vs. 7.4 KJ, p = 0.05) and energy consumption (8.8 vs. 7.2 J/mm³, p = 0.04) were significantly lower, mean ablation speed was higher despite not significantly different (1.3 vs. 1.5 mm³/s, p = 0.11). In the TFL group fragments retrieval with a basket was significantly more frequent. SFR and complication rate were comparable.

Holmium: YAG Cyber Ho laser generator with the new pulse modulation Magneto technology has comparable efficacy and safety profile to TFL in the percutaneous treatment of renal stones ≤ 20 mm. Magneto showed a higher dusting efficiency in terms of energy consumption and complete dusting, and a favourable profile in terms of lasing time and ablation speed, despite without statistical significance.