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Review
. 2021 Mar;62(2):136-147.
doi: 10.4111/icu.20200467.

Thulium fiber laser utilization in urological surgery: A narrative review

Johnathan A Khusid  1 , Raymond Khargi  2 , Benjamin Seiden  2 , Areeba S Sadiq  3 , William M Atallah  3 , Mantu Gupta  3
Affiliations
Review

Thulium fiber laser utilization in urological surgery: A narrative review

Johnathan A Khusid et al. Investig Clin Urol. 2021 Mar.

Abstract

The thulium fiber laser (TFL) is a novel technology under active investigation as an conceivable alternative to the Holmium:yttrium-aluminum-garnet (Ho:YAG) laser, which is currently the gold standard for an array of urologic procedures. The purpose of this review is to discuss the existing literature on the functionality and effectiveness of TFL in urological practice. We conducted a search of the PubMed, Medline, Web of Science Core Collection, SCOPUS, Embase (OVID), and Cochrane Databases for all full articles and systematic reviews on the TFL. We found a total of 35 relevant pieces of literature. The early research findings pertaining to the TFL exhibit numerous potential advantages over the Ho:YAG laser. In vitro and ex vivo studies have highlighted the TFL's ability to utilize smaller laser fibers, obtain faster stone ablation rates, and achieve less retropulsion when tested against the Ho:YAG laser in lithotripsy. Currently, there is limited in vivo research that investigates the utilization of the TFL. The in vivo results that are available, however, look promising both for laser lithotripsy and soft tissue ablation. Indeed, the existing literature suggests that the TFL has great potential and may possess numerous technological advantages over the Ho:YAG laser, especially in laser lithotripsy. Although these early studies are promising, randomized control trials are needed to assess the full applicability of the TFL in urology.

Keywords: Laser therapy; Lithotripsy; Surgical endoscopy; Thulium; Urology.

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Conflict of interest statement

Dr. Mantu Gupta is compensated for educational training for Cook Urological Inc., Boston Scientific Inc., Olympus Inc., Lumenis Inc., and Retrophin Inc. Additionally, Dr. Gupta is the Editor in Chief for Video Urology. No other authors have any relevant conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Flowchart illustrating literature review. TFL, thulium fiber laser; Ho:YAG, holmium:yttrium-aluminum-garnet laser; Tm:YAG, thulium:yttrium-aluminium-garnet laser.
See this image and copyright information in PMC

References

    1. Adkins WC, Dulabon DA, Chorazy ZJ, Lund PS, Johnson LM, Jones WV. Consider Ho:YAG for low-cost, effective laser lithotripsy. Clin Laser Mon. 1994;12:139–141. - PubMed
    1. Kronenberg P, Traxer O. Update on lasers in urology 2014: current assessment on holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripter settings and laser fibers. World J Urol. 2015;33:463–469. - PubMed
    1. Matsuoka K, Iida S, Nakanami M, Koga H, Shimada A, Mihara T, et al. Holmium: yttrium-aluminum-garnet laser for endoscopic lithotripsy. Urology. 1995;45:947–952. - PubMed
    1. Nazif OA, Teichman JM, Glickman RD, Welch AJ. Review of laser fibers: a practical guide for urologists. J Endourol. 2004;18:818–829. - PubMed
    1. Dornier MedTech. Dornier Medilas® H 140 specification sheet. Munich: Dornier MedTech; 2018.