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Pulsed Thulium:YAG Laser-Ready To Dust All Urinary Stone Composition Types? Results From a PEARLS Analysis - Beyond the Abstract

The novel pulsed thulium:yttrium-aluminium-garnet (p-Tm:YAG) laser has only been recently introduced into clinical practice. The authors questioned whether the novel p-Tm:YAG laser is able to dust all known prevailing human urinary stone compositions. Senior urologists would remember the frequency-doubled double-pulse neodymium:YAG (FREDDY) laser which was originally looked at as a potential lithotripsy tool, till it was found ineffective against cystine stones.1,2

Thus, the authors used the p-Tm:YAG laser against human urinary stones of all seven prevailing stone types in vitro. Post lithotripsy stone samples were then analysed. Strict criteria were applied to the size of particles produced, using a previously proposed stone size limit of ≤ 250 µm for the definition of stone dust.3

The authors believe that the findings of the study form part of foundational research approving new technology in lithotripsy, and are pivotal for the wider future application of the novel p-Tm:YAG in everyday clinical routine.



Written by: Jia-Lun Kwok, MBBS, FRCS1,2 and Etienne Xavier Keller, MD, FEBU1

  1. Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
  2. Department of Urology, Tan Tock Seng Hospital, Singapore, Singapore
References:

  1. Dubosq F, Pasqui F, Girard F, Beley S, Lesaux N, Gattegno B, et al. Endoscopic lithotripsy and the FREDDY laser: Initial experience. Journal of Endourology. 2006;20(5):296-9. doi: 10.1089/end.2006.20.296.
  2. Yates J, Zabbo A, Pareek G. A comparison of the FREDDY and holmium lasers during ureteroscopic lithotripsy. Lasers in Surgery and Medicine. 2007;39(8):637-40. doi: 10.1002/lsm.20545.
  3. Keller EX, De Coninck V, Doizi S, Daudon M, Traxer O. What is the exact definition of stone dust? An in vitro evaluation. World Journal of Urology. 2021;39(1):187-94. doi: 10.1007/s00345-020-03178-z.
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