2021
DOI: 10.1089/end.2019.0441
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How Lasers Ablate Stones: In Vitro Study of Laser Lithotripsy (Ho:YAG and Tm-Fiber Lasers) in Different Environments

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Cited by 45 publications
(31 citation statements)
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“…The TFL is called a fibre laser because the laser beam is generated inside a very small core laser fibre (the gain medium) within the laser generator, whereas Ho:YAG lasers use laser rods inside resonance chambers with complex optical systems and precision alignment [ 7 ▪ , 8 ▪ ]. Although Ho:YAG Lasers use laser radiation at 2100 nm wavelength, the TFL uses 1940 nm wavelength and its radiation absorption is four times higher in water, which is probably the reason for its higher ablation efficiency of any type of urinary calculi (see below) [ 21 , 22 ▪▪ ]. Although Ho:YAG lasers are big, heavy, power-hungry machines that need dedicated high-power outlets and use noisy water cooling, TFL machines are several times lighter, smaller, use quiet air-cooling mechanisms, that consume less energy and can be run from a standard power outlet [ 8 ▪ , 10 , 23 – 26 ].…”
Section: Thulium Fibre Laser Machine Specificationsmentioning
confidence: 99%
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“…The TFL is called a fibre laser because the laser beam is generated inside a very small core laser fibre (the gain medium) within the laser generator, whereas Ho:YAG lasers use laser rods inside resonance chambers with complex optical systems and precision alignment [ 7 ▪ , 8 ▪ ]. Although Ho:YAG Lasers use laser radiation at 2100 nm wavelength, the TFL uses 1940 nm wavelength and its radiation absorption is four times higher in water, which is probably the reason for its higher ablation efficiency of any type of urinary calculi (see below) [ 21 , 22 ▪▪ ]. Although Ho:YAG lasers are big, heavy, power-hungry machines that need dedicated high-power outlets and use noisy water cooling, TFL machines are several times lighter, smaller, use quiet air-cooling mechanisms, that consume less energy and can be run from a standard power outlet [ 8 ▪ , 10 , 23 – 26 ].…”
Section: Thulium Fibre Laser Machine Specificationsmentioning
confidence: 99%
“…Even comparisons with high-power Ho:YAG lasers equipped with pulse modulating Moses technology from Lumenis [ 26 ] showed the superior lithotripsy performance of the TFL technology, sometimes by a factor of 3 [ 20 , 33 – 36 ]. One of the reasons for this improved performance is the steady and prolonged peak power levels that the TFL is capable of delivering associated with its four times higher wavelength absorption in water, thereby causing explosive thermomechanical interactions in addition to the already known photothermal effects [ 14 ▪▪ , 20 , 21 , 22 ▪▪ ]. Still, there are some debatable results such as accrediting solely the higher frequencies of the TFLs for its increased ablation speeds, less retropulsion or operating room time reduction [ 37 ], in spite of the use of lower pulse energies together with higher frequencies or the higher ablation performance per Joule of TFL energy.…”
Section: Ablation Efficiencymentioning
confidence: 99%
“…It has already shown effective fragmentation and dusting during retrograde intrarenal surgery and percutaneous nephrolithotomy 8,9 . Moreover, its ability to use higher pulse frequencies (up to 300 Hz) and lower minimum pulse energy has already been shown to be superior in in vitro studies and in clinical trials 10,11 …”
Section: Introductionmentioning
confidence: 99%
“…8,9 Moreover, its ability to use higher pulse frequencies (up to 300 Hz) and lower minimum pulse energy has already been shown to be superior in in vitro studies and in clinical trials. 10,11 To date, the SuperPulsed TFL (NTO IRE-Polus, Fryazino, Russia) has proven efficacy in in vitro experiments, 12 but no clinical trials on lithotripsy for ureteral stones have been performed. To address this gap we aimed to share our experience in this procedure and specify the features and benefits of using different laser modes.…”
Section: Introductionmentioning
confidence: 99%
“…Its prospective single‐center design did not allow the comparison of SP TFL with Ho:YAG laser for ureteral lithotripsy. Furthermore, the optimal settings for SP TFL were previously established in a series of in vitro tests 3 . However, the study showed the real profile data on SP TFL for ureteral lithotripsy, demonstrating its efficacy and safety during ureteroscopy based on the need for low energy and short laser time.…”
mentioning
confidence: 99%