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. 2021 Mar 1;31(2):80-86.
doi: 10.1097/MOU.0000000000000853.

Outcomes of thulium fibre laser for treatment of urinary tract stones: results of a systematic review

Peter Kronenberg  1 , Bm Zeeshan Hameed  2 , Bhaskar Somani  3
Affiliations

Outcomes of thulium fibre laser for treatment of urinary tract stones: results of a systematic review

Peter Kronenberg et al. Curr Opin Urol. .

Abstract

Purpose of review: Lasers have become a fundamental aspect of stone treatment. Although Holmium:Yttrium-Aluminum-garnet (Ho:YAG) laser is the current gold-standard in endoscopic laser lithotripsy, there is a lot of buzz around the new thulium fibre laser (TFL). We decided to evaluate the latest data to help create an objective and evidence-based opinion about this new technology and associated clinical outcomes.

Recent findings: Sixty full-text articles and peer-reviewed abstract presentations were included in the qualitative synthesis of this systematic review performed over the last 2 years. Current super pulsed TFL machines are capable of achieving peak powers of 500W and emit very small pulse energies of 0.025 Joules going up to 6 Joules, and capable of frequency over 2000 Hz. This makes the TFL ablate twice as fast for fragmentation, 4 times as fast for dusting, more stone dust of finer size and less retropulsion compared to the Ho:YAG laser. Because of the smaller laser fibres with the TFL, future miniaturization of instruments is also possible.

Summary: Based on the review, the TFL is a potential game-changer for kidney stone disease and has a promising role in the future. However larger multicentric prospective clinical studies with long-term follow-up are needed to establish the safety and efficacy of the TFL in endourology.

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Conflict of interest statement

Peter Kronenberg has participated in advisory board meetings for Olympus and in industry breakout session for Lumenis. Bhaskar Somani has participated in industry session for Lumenis.

Figures

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FIGURE 1
FIGURE 1
Flow chart documenting the source of information selection process through the different phases, according to PRISMA guidelines [13].
See this image and copyright information in PMC

References

    1. Kronenberg P, Somani B. Advances in lasers for the treatment of stones-a systematic review. Curr Urol Rep 2018; 19:45. - PMC - PubMed
    1. Fried NM, Irby PB. Advances in laser technology and fibre-optic delivery systems in lithotripsy. Nat Rev Urol 2018; 15:563–573. - PubMed
    1. Traxer O, Rapoport L, Tsarichenko D, et al. V03-02 first clinical study on superpulse thulium fiber laser for lithotripsy. J Urol 2018; 199: 4 Supplement: e321–e322.
    1. Kronenberg P. [[Accessed October 22, 2020]]. AUA Live: Thulium fiber laser may become the new lithotripsy gold standard; 2020. Available from: https://www.auadailynews.org/aua-live-thulium-fiber-laser-may-become-the...
    1. [[Accessed October 21, 2020]]. Olympus Launches the Soltive SuperPulsed Thulium Fiber Laser System for Urology; 2020. Available from: https://infomeddnews.com/olympus-launches-the-soltive-superpulsed-thuliu...

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