Comparing dusting and fragmenting efficiency using the new SuperPulsed thulium fiber laser versus a 120 W Holmium:YAG laser

Abstract

Purpose: Holmium:YAG laser lithotripsy requires high amperage power and has an upper limit of frequency and a minimal fiber size. The technology utilizing thulium-doped fiber offers low pulse energy settings and high pulse frequencies up to 2,400 Hz. We compared the novel SuperPulsed thulium fiber laser (SOLTIVE™; Olympus) to a commercially available 120 W Ho:YAG laser. Materials and Methods: Bench-top testing was conducted with 125 mm3 standardized BegoStones (Bego USA). Time to ablate the stone into particles 2 mm remained using SOLTIVE™ than Ho:YAG laser (2.10 vs. 7.20 fragments). After delivering 2 kJ, dusting (1.05±0.08 mg/s) was faster using SOLTIVE™ (0.1 J 200 Hz short pulse) than 120 W 0.46±0.09 mg/s (0.3 J 70 Hz Moses) (p=0.005). SOLTIVE™ (0.1 J 200 Hz) produced more dust particles <0.5 mm (40%) compared to 24% produced by the P120 W laser at 0.3 J 70 Hz Moses and 14% at 0.3 J 70 Hz long pulse (p=0.015). Conclusions: The efficacy of SOLTIVE™ is superior to the 120 W Ho:YAG laser by producing smaller dust particles and fewer fragments. Further studies are warranted.

Keywords

• holmium
• lithotripsy
• laser
• thulium
• ureteroscopy