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Ho

YaG laser lithotripsy

recent innovations

Becker, Benedikt; Gross, Andreas J.; Netsch, Christopher

doi: 10.1097/MOU.0000000000000573
FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Arkadiusz Miernik
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Purpose of review The aim of this study was to summarize the recent innovations of the holmium laser with special respect to lithotripsy. Therefore, we reviewed and discussed the most recent and pivotal publications on this topic.

Recent findings The current literature underlines Holmium:yttrium-aluminium-garnet (Ho:YAG) lithotripsy as a well tolerated and efficient method to treat urinary calculi. Because of modifiable adjustments of pulse energy, pulse frequency, and pulse length, especially with newer generations of holmium lasers, urologists can accurately choose between the ‘fragmentation’ and ‘dusting’ technique with its alterations. Recently, the ‘Moses mode’ as a new feature incorporated in the Lumenis Pulse P120H holmium laser showed less retropulsion with higher rates of stone ablation because of an improved energy transmission from the laser fiber towards the targeted calculus in in-vitro studies.

Summary Based on technological developments, Ho:YAG laser lithotripsy has become more efficient in reducing retropulsion and increasing stone ablation volume. However, despite its widespread use as a lithotripter, a newly developed thulium fiber laser, which has already shown promising results in experimental studies, could become an alternative in future practice.

Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany

Correspondence to Benedikt Becker, Department of Urology, Asklepios Hospital Barmbek, Rübenkamp 220, 22291 Hamburg, Germany. Tel: +49 40 1818 82 9821; fax: +49 40 1818 82 9829; e-mail: ben.becker@asklepios.com

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