Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Lasers in Medical Science
Published in: Lasers in Medical Science 3/2022

01-04-2022 | Urolithiasis | Original Article

In vitro fragmentation performance of a novel, pulsed Thulium solid-state laser compared to a Thulium fibre laser and standard Ho:YAG laser

Authors: Lea Kraft, Ralf Petzold, Rodrigo Suarez-Ibarrola, Arkadiusz Miernik

Published in: Lasers in Medical Science | Issue 3/2022

Login to get access

Abstract

The aim of this work was to compare the fragmentation efficiency of a novel, pulsed Thulium solid-state laser (p-Tm:YAG) to that of a chopped Thulium fibre laser (TFL) and a pulsed Holmium solid-state laser (Ho:YAG). During the fragmentation process, we used a silicone mould to fixate the hemispherical stone models under water in a jar filled with room-temperature water. Each laser device registered the total energy applied to the stone model to determine fragmentation efficiency. Our study examined laser settings with single pulse energies ranging from 0.6 to 6 J and pulse frequencies ranging from 5 to 15 Hz. Similar laser settings were applied to explicitly compare the fragmentation efficiency of all three devices. We experimented with additional laser settings to see which of the three devices would perform best. The fragmentation performance of the three laser devices differed statistically significantly (p < 0.05). The average total energy required to fragment the stone model was 345.96 J for Ho:YAG, 372.43 J for p-Tm:YAG and 483.90 J for TFL. To fragment the stone models, both Ho:YAG and p-Tm:YAG needed similar total energy (p = 0.97). TFL’s fragmentation efficiency is significantly lower than that of Ho:YAG and p-Tm:YAG. Furthermore, we found the novel p-Tm:YAG’s fragmentation efficiency to closely resemble that of Ho:YAG. The fragmentation efficiency is thought to be influenced by the pulse duration. TFL’s shortest possible pulse duration was considerably longer than that of Ho:YAG and p-Tm:YAG, resulting in Ho:YAG and p-Tm:YAG exhibiting better fragmenting efficiency.
Literature
1.
Hesse A et al (2003) Study on the prevalence and incidence of urolithiasis in Germany comparing the years 1979 vs. 2000. Eur Urol 44:709–13CrossRef
2.
3.
Bell JR, Penniston KL, Nakada SY (2017) In vitro comparison of stone fragmentation when using various settings with modern variable pulse holmium lasers. J Endourol 31(10):1067–1072CrossRef
4.
El-Nahas AR et al (2019) Dusting versus fragmentation for renal stones during flexible ureteroscopy. Arab J Urol 17(2):138–142CrossRef
5.
Tracey J et al (2018) Ureteroscopic high-frequency dusting utilizing a 120-W holmium laser. J Endourol 32(4):290–295CrossRef
6.
Doizi S, Keller EX, De Coninck V, Traxer O (2018) Dusting technique for lithotripsy: what does it mean?. Nat Rev Urol 15(11):653–654CrossRef
7.
Black KM, Aldoukhi AH, Ghani KR (2019) A users guide to holmium laser lithotripsy settings in the modern era. Front Surg 6:48CrossRef
8.
Matlaga BR et al (2018) Ureteroscopic laser lithotripsy: a review of dusting vs fragmentation with extraction. J Endourol 32(1):1–6CrossRef
9.
Hardy LA et al (2018) Fragmentation and dusting of large kidney stones using compact, air-cooled, high peak power, 1940-nm, Thulium fiber laser. Therapeutics and diagnostics in urology 2018. International Society for Optics and Photonics
10.
Santiago JE et al (2017) To dust or not to dust: a systematic review of ureteroscopic laser lithotripsy techniques. Curr Urol Rep 18(4):32CrossRef
11.
Wenzel M, Bultitude M, Salem J (2019) Dusting, fragmenting, popcorning or dustmenting? Curr Opin Urol 29(2):108–112CrossRef
12.
13.
Becker A et al (2020) Der “Super Pulse” Thulium Faser Laser - Neuerungen im Bereich der Endourologie. UroForum 09:5
14.
Traxer O, Keller EX (2019) Thulium fiber laser: the new player for kidney stone treatment? A comparison with Holmium:YAG laser. World J Urol 38(8):1883–1894CrossRef
15.
Hardy LA, Vinnichenko V, Fried NM (2019) High power holmium:YAG versus thulium fiber laser treatment of kidney stones in dusting mode: ablation rate and fragment size studies. Lasers Surg Med 51(6):522–530CrossRef
16.
Enikeev D et al (2020) A review of thulium-fiber laser in stone lithotripsy and soft tissue surgery. Curr Opin Urol 30(6):853–860CrossRef
17.
Petzold R, Miernik A, Suarez-Ibarrola R (2020) In vitro dusting performance of a new solid state thulium laser compared to holmium laser lithotripsy. J Endourol
18.
Wezel F et al (2010) Effect of pulse energy, frequency and length on holmium: yttrium-aluminum-garnet laser fragmentation efficiency in non-floating artificial urinary calculi. J Endourol 24(7):1135–1140CrossRef
19.
Vinnichenko V et al (2018) Comparison of a novel 450-nm laser with Ho:YAG (2100 nm), Tm fiber (1940 nm), and KTP (532 nm) lasers for soft-tissue ablation. SPIE BiOS. 10468: SPIE
20.
Williams JG et al (2020) A temperature model for laser lithotripsy. World J Urol 39(6):1707–1716CrossRef
21.
Hein S et al (2018) Thermal effects of Ho: YAG laser lithotripsy: real-time evaluation in an in vitro model. World J Urol 36(9):1469–1475CrossRef
22.
Hein S et al (2020) Thermal effects of Ho: YAG laser lithotripsy during retrograde intrarenal surgery and percutaneous nephrolithotomy in an ex vivo porcine kidney model. World J Urol 38(3):753–760CrossRef
23.
Bader MJ et al (2015) Impact of pulse duration on Ho:YAG laser lithotripsy: fragmentation and dusting performance. World J Urol 33(4):471–477CrossRef
24.
Bell JR, Penniston KL, Nakada SY (2017) In vitro comparison of holmium lasers: evidence for shorter fragmentation time and decreased retropulsion using a modern variable-pulse laser. Urology 107:37–42CrossRef
25.
Aldoukhi AH et al (2021) Patterns of laser activation during ureteroscopic lithotripsy: effects on caliceal fluid temperature and thermal dose. J Endourol 35(8):1217–1222CrossRef
26.
Alghamdi A et al (2020) Influence of the laser pulse shape in the treatment of stones in the upper urinary tract. Investig Clin Urol 61(6):594–599CrossRef
27.
Nyame YA et al (2015) Kidney stone models for in vitro lithotripsy research: a comprehensive review. J Endourol 29(10):1106–1109CrossRef
Metadata
Title
In vitro fragmentation performance of a novel, pulsed Thulium solid-state laser compared to a Thulium fibre laser and standard Ho:YAG laser
Authors
Lea Kraft
Ralf Petzold
Rodrigo Suarez-Ibarrola
Arkadiusz Miernik
Publication date
01-04-2022
Publisher
Springer London
Published in
Lasers in Medical Science / Issue 3/2022
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-021-03495-8

Other articles of this Issue 3/2022

Lasers in Medical Science 3/2022 Go to the issue

Review Article

Effects of low-level laser therapy on reducing pain, edema, and trismus after orthognathic surgery: a systematic review

Original Article

Photobiomodulation intervention improves oxidative, inflammatory, and morphological parameters of skeletal muscle in cirrhotic Wistar rats

Original Article

Laser interstitial thermal therapy for newly diagnosed glioblastoma

Original Article

Triple pass laser therapy for recalcitrant facial port wine stains

Original Article

Monte Carlo simulations of photodynamic therapy in human blood model

Original Article

Impact of preconditioned diabetic stem cells and photobiomodulation on quantity and degranulation of mast cells in a delayed healing wound simulation in type one diabetic rats