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Organo Oficial de la Sociedad Mexicana de Urología

2023, Number 1

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Rev Mex Urol 2023; 83 (1)

Thulium Fiber Laser: game changer or marketing hype?

Gonzalez-Cuenca E, Razvi H

Language: English
References: 33
Page:
PDF size: 234.88 Kb.


ABSTRACT

Description: The Holmium: yttrium-aluminum-garnet (Ho:- YAG) laser has become the gold-standard intracorporeal lithotripsy device since it was first introduced in the 1980’s. More recently, the Thulium Fiber Laser (TFL) was introduced into the clinical setting, with the potential to address some of the inherent limitations with Ho:YAG devices. In particular, early experience suggested the TFL provided enhanced dusting and fragmenting capabilities, less retropulsion and better stone free rates compared to the Ho:YAG laser.
Relevance: Should the initial claims of the TFL’s better dusting properties be confirmed, this would be a significant advancement in the field. The ability to dust larger stones more rapidly could enhance the role of ureteroscopy and reduce the need for more invasive procedures.
Conclusion: The initial experience with the TFL is promising and suggests an advantage over Ho:YAG laser lithotripsy. Properly conducted prospective randomized trials are required to further delineate the advantages, disadvantages and to optimize patient outcomes.


REFERENCES

  1. Coptcoat MJ, Ison KT, Watson G, WickhamJE. Lasertripsy for ureteric stones in 120 cases:lessons learned. British Journal of Urology.1988;61(6): 487–489. https://doi.org/10.1111/j.1464-410x.1988.tb05085.x.

  2. Hofmann R, Hartung R. Use of pulsed Nd:YAGlaser in the ureter. The Urologic Clinics of NorthAmerica. 1988;15(3): 369–375. https://doi.org/10.1016/S0094-0143(21)01578-0.

  3. Sayer J, Johnson DE, Price RE, Cromeens DM.Ureteral Lithotripsy with the Holmium:YAGLaser. Journal of Clinical Laser Medicine &Surgery. 1993;11(2): 61–65. https://doi.org/10.1089/clm.1993.11.61.

  4. Denstedt JD, Razvi HA, Sales JL, EberweinPM. Preliminary experience with holmium:YAG laser lithotripsy. Journal of Endourology.1995;9(3): 255–258. https://doi.org/10.1089/end.1995.9.255.

  5. Chan KF, Pfefer TJ, Teichman JM, WelchAJ. A perspective on laser lithotripsy:the fragmentation processes. Journal ofEndourology. 2001;15(3): 257–273. https://doi.org/10.1089/089277901750161737.

  6. Pierre S, Preminger GM. Holmium laser forstone management. World Journal of Urology.2007;25(3): 235–239. https://doi.org/10.1007/s00345-007-0162-y.

  7. Vassar GJ, Chan KF, Teichman JM, GlickmanRD, Weintraub ST, Pfefer TJ, et al. Holmium:YAG lithotripsy: photothermal mechanism.Journal of Endourology. 1999;13(3): 181–190.https://doi.org/10.1089/end.1999.13.181.

  8. Fried NM. Recent advances in infraredlaser lithotripsy [Invited]. Biomedical OpticsExpress. 2018;9(9): 4552–4568. https://doi.org/10.1364%2FBOE.9.004552.

  9. Ventimiglia E, Traxer O. What Is Moses Effect:A Historical Perspective. Journal of Endourology.2019;33(5): 353–357. https://doi.org/10.1089/end.2019.0012.

  10. Isner J, Clarke R, Katzir A, Gal D, DeJesus S,Halaburka K. Transmission characteristics ofindividual wavelengths in blood do not predictability to accomplish laser ablation in a bloodfield-inferential evidence for the moses effect.In: Circulation. AMER HEART ASSOC 7272GREENVILLE AVENUE, DALLAS, TX 75231-4596; 1986. p. 361–361.

  11. Traxer O, Keller EX. Thulium fiber laser: thenew player for kidney stone treatment? Acomparison with Holmium:YAG laser. WorldJournal of Urology. 2020;38(8): 1883–1894.https://doi.org/10.1007/s00345-019-02654-5.

  12. Kronenberg P, Traxer O. The laser of the future:reality and expectations about the new thuliumfiber laser-a systematic review. TranslationalAndrology and Urology. 2019;8(Suppl 4): S398–S417. https://doi.org/10.21037/tau.2019.08.01.

  13. Kronenberg P, Hameed BZ, SomaniB. Outcomes of thulium fibre laser fortreatment of urinary tract stones: results of asystematic review. Current Opinion in Urology.2021;31(2): 80–86. https://doi.org/10.1097/mou.0000000000000853.

  14. Razvi HA, Denstedt JD, Chun SS, SalesJL. Intracorporeal Lithotripsy With theHolmium:YAG Laser. Journal of Urology.1996;156(3): 912–914. https://doi.org/10.1016/S0022-5347(01)65661-1.

  15. Fried NM. Thulium fiber laser lithotripsy: anin vitro analysis of stone fragmentation usinga modulated 110-watt Thulium fiber laser at1.94 microm. Lasers in Surgery and Medicine.2005;37(1): 53–58. https://doi.org/10.1002/lsm.20196.

  16. Blackmon RL, Irby PB, Fried NM. Holmium:YAG(lambda = 2,120 nm) versus thulium fiber(lambda = 1,908 nm) laser lithotripsy. Lasersin Surgery and Medicine. 2010;42(3): 232–236.https://doi.org/10.1002/lsm.20893.

  17. Hardy LA, Vinnichenko V, Fried NM. Highpower holmium:YAG versus thulium fiber lasertreatment of kidney stones in dusting mode:ablation rate and fragment size studies. Lasersin Surgery and Medicine. 2019;51(6): 522–530.https://doi.org/10.1002/lsm.23057.

  18. Hardy LA, Wilson CR, Irby PB, Fried NM.Thulium fiber laser lithotripsy in an invitro ureter model. Journal of BiomedicalOptics. 2014;19(12): 128001. https://doi.org/10.1117/1.jbo.19.12.128001.

  19. Blackmon RL, Irby PB, Fried NM. Comparisonof holmium:YAG and thulium fiber laserlithotripsy: ablation thresholds, ablation rates,and retropulsion effects. Journal of BiomedicalOptics. 2011;16(7): 071403. https://doi.org/10.1117/1.3564884.

  20. Panthier * Frederic, Doizi S, Berthe L, TraxerO. Pd04-12 in vitro comparison of ablationrates between superpulsed thulium fiber laserand ho:yag laser for endocorporeal lithotripsy.Journal of Urology. 2020;203(Supplement4): e83–e83. https://doi.org/10.1097/JU.0000000000000824.012.

  21. Andreeva V, Vinarov A, Yaroslavsky I,Kovalenko A, Vybornov A, Rapoport L, et al.Preclinical comparison of superpulse thuliumfiber laser and a holmium:YAG laser forlithotripsy. World Journal of Urology. 2020;38(2):497–503. https://doi.org/10.1007/s00345-019-02785-9.

  22. Knudsen * Bodo, Chew B, Molina W.Mp79-16 super pulse thulium fiber lasercompared to 120w holmium:yag laser: impacton retropulsion and laser fiber burn back.Journal of Urology. 2019;201(Supplement 4):e1157–e1158. https://doi.org/10.1097/01.JU.0000557395.71689.0d.

  23. Martov AG, Ergakov DV, Guseinov MA,Andronov AS, Dutov SV, Vinnichenko VA, etal. [Initial experience in clinical application ofthulium laser contact lithotripsy for transurethraltreatment of urolithiasis]. Urologiia (Moscow,Russia: 1999). 2018;(1): 112–120. https://dx.doi.org/10.18565/urology.2018.1.112-120.

  24. Carrera RV, Randall JH, Garcia-Gil M,Knudsen BE, Chew BH, Thompson JA, et al.Ureteroscopic Performance of High Power SuperPulse Thulium Fiber Laser for the Treatmentof Urolithiasis: Results of the First Case Seriesin North America. Urology. 2021;153: 87–92.https://doi.org/10.1016/j.urology.2020.12.054.

  25. Corrales M, Traxer O. Initial clinical experiencewith the new thulium fiber laser: first 50 cases.World Journal of Urology. 2021;39(10): 3945–3950. https://doi.org/10.1007/s00345-021-03616-6.

  26. Enikeev D, Taratkin M, Klimov R, InoyatovJ, Azilgareeva C, Ali S, et al. SuperpulsedThulium Fiber Laser for Stone Dusting: InSearch of a Perfect Ablation Regimen-AProspective Single-Center Study. Journal ofEndourology. 2020;34(11): 1175–1179. https://doi.org/10.1089/end.2020.0519.

  27. Ulvik Ø, Æsøy MS, Juliebø-Jones P,Gjengstø P, Beisland C. Thulium Fibre Laserversus Holmium:YAG for UreteroscopicLithotripsy: Outcomes from a ProspectiveRandomised Clinical Trial. European Urology.2022;82(1): 73–79. https://doi.org/10.1016/j.eururo.2022.02.027.

  28. Haas CR, Knoedler MA, Li S, Gralnek DR,Best SL, Penniston KL, et al. Pulse-modulatedHolmium:YAG Laser vs the Thulium FiberLaser for Renal and Ureteral Stones: A SinglecenterProspective Randomized ClinicalTrial. The Journal of Urology. 2023;209(2):374–383. https://doi.org/10.1097/JU.0000000000003050.

  29. Sierra A, Corrales M, Piñero A, TraxerO. Thulium fiber laser pre-settings duringureterorenoscopy: Twitter’s experts’recommendations. World Journal of Urology.2022;40(6): 1529–1535. https://doi.org/10.1007/s00345-022-03966-9.

  30. Dymov * Alim, Rapoport L, TsarichenkoD, Enikeev D, Sorokin N, Akopyan G, etal. Pd01-06 prospective clinical study onsuperpulse thulium fiber laser: initial analysisof optimal laser settings. Journal of Urology.2019;201(Supplement 4): e58–e58. https://doi.org/10.1097/01.JU.0000555018.13063.41.

  31. Enikeev D, Grigoryan V, Fokin I, MorozovA, Taratkin M, Klimov R, et al. Endoscopiclithotripsy with a SuperPulsed thulium-fiberlaser for ureteral stones: A single-centerexperience. International Journal of Urology:Official Journal of the Japanese UrologicalAssociation. 2021;28(3): 261–265. https://doi.org/10.1111/iju.14443.

  32. Enikeev D, Shariat SF, Taratkin M,Glybochko P. The changing role of lasers inurologic surgery. Current Opinion in Urology.2020;30(1): 24–29. https://doi.org/10.1097/mou.0000000000000695.

  33. Molina WR, Carrera RV, Chew BH, KnudsenBE. Temperature rise during ureteral laserlithotripsy: comparison of super pulse thuliumfiber laser (SPTF) vs high power 120 Wholmium-YAG laser (Ho:YAG). World Journal ofUrology. 2021;39(10): 3951–3956. https://doi.org/10.1007/s00345-021-03619-3.




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