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Thulium:YAG laser: a good compromise between holmium:YAG and thulium fiber laser for endoscopic lithotripsy? A narrative review

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Abstract

Purpose

To provide a technological description of the new pulsed solid-state Thulium:YAG laser (Tm:YAG). In addition, current available literature on Tm:YAG lithotripsy is also reviewed.

Materials and methods

Medline, Scopus, Embase, and Web of Science databases were used to search for Tm:YAG operating mode articles.

Results

Tm:YAG technology works with a laser cavity with thulium-doped YAG crystal, pumped by laser diodes. Laser beam operates at 2013 nm, with an adjustable peak power (≥ 1000 W) and the minimal fiber laser diameter is of 200 µm. It has an intermediate water absorption coefficient and peak power-pulse duration. Various pulse modulations are proposed, aiming to minimize stone retropulsion. Multiple comparative in vitro studies suggest that Tm:YAG’s ability to fragment stones is similar to the one of the Ho:YAG laser; on the contrary, its ability to dust all stone types is similar to the one of the TFL, with a low retropulsion. A single in vivo study assessed Tm:YAG lithotripsy feasibility.

Conclusions

The new pulsed solid-state thulium:YAG laser could represent a safe and effective compromise between Ho:YAG laser and TFL for endoscopic lithotripsy, either in retrograde intra-renal surgeries or in percutaneous nephrolithotomy.

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Data availability

Data is available on request to the corresponding authors.

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Funding

No funding to declare for this study.

Author information

Authors and Affiliations

  1. GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France

    Marie Chicaud, Mariela Corrales, Stessy Kutchukian, Catalina Solano, Luigi Candela, Steeve Doizi, Olivier Traxer & Frédéric Panthier

  2. Service d’Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France

    Marie Chicaud, Mariela Corrales, Stessy Kutchukian, Catalina Solano, Luigi Candela, Steeve Doizi, Olivier Traxer & Frédéric Panthier

  3. PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l’Hôpital, 75013, Paris, France

    Marie Chicaud, Stessy Kutchukian, Steeve Doizi & Frédéric Panthier

  4. Service d’Urologie, CHU Limoges, 87000, Limoges, France

    Marie Chicaud

  5. Department of Urology, Poitiers University Hospital, 2 Rue de la Milétrie, 86000, Poitiers, France

    Stessy Kutchukian

  6. Department of endourology, Uroclin SAS, Medellin, Colombia

    Catalina Solano

  7. Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy

    Luigi Candela

  8. Vital-Salute San Raffaele University, Milan, Italy

    Luigi Candela

Authors
  1. Marie Chicaud
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  2. Mariela Corrales
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  3. Stessy Kutchukian
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  4. Catalina Solano
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  5. Luigi Candela
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  6. Steeve Doizi
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  7. Olivier Traxer
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  8. Frédéric Panthier
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Contributions

FP: project development, data collection and management, data analysis, manuscript writing et editing. MC: project development, data collection and management, manuscript writing et editing. MC: manuscript writing et editing. SK: data collection and management. CS: manuscript writing et editing. LC: manuscript writing et editing. SD: project development, manuscript writing et editing. OT: project development, data analysis, manuscript writing et editing.

Corresponding author

Correspondence to Frédéric Panthier.

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Conflict of interest

The authors declare that they have no conflict of interest but: Frédéric Panthier has declared as consultant for Dornier. Olivier Traxer has declared as consultant for Karl Storz, Coloplast, IPG photonics, Ambu, Quanta System and Rocamed. Steeve Doizi has declared as consultant for Boston Scientific Corporation and Coloplast.

Informed consent

This article does not contain any studies with human participants or animals performed by any of the authors. Human stone samples were used in this study, with the informed consent of each patient.

Research involving human participants or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

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Chicaud, M., Corrales, M., Kutchukian, S. et al. Thulium:YAG laser: a good compromise between holmium:YAG and thulium fiber laser for endoscopic lithotripsy? A narrative review. World J Urol 41, 3437–3447 (2023). https://doi.org/10.1007/s00345-023-04679-3

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  • DOI: https://doi.org/10.1007/s00345-023-04679-3

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