Urinary stone disease has become increasingly prevalent worldwide. For over three decades, the laser has been established as the mainstay for endourological surgery and lithotripsy. The introduction of novel pulsed thulium:yttrium–aluminum–garnet (p-Tm:YAG) laser technology for clinical use indicates promising results in terms of ablation efficiency. However, existing studies are predominantly based on non-human stone models or stones with unknown composition. The following two in vitro studies aim to assess ablation efficiency and the resulting particle sizes of the p-Tm:YAG laser (Dornier Thulio®) when used with the seven most common human urinary stone types.
Study 1: Pulsed thulium:YAG laser – ready to dust all urinary stone composition types? Results from a PEARLS analysis1
Conclusion: The novel p-Tm: YAG laser (Dornier Thulio®) is capable of dusting all seven common human urinary stone compositions, yielding dust particles of ≤ 250 µm, aligning with the established definition of stone dust. These findings are pivotal for the wider adoption of p-Tm:YAG laser in clinical practice.
Study 2: Pulsed Thulium:YAG laser – What is the lithotripsy ablation efficiency for stone dust from human urinary stones? Results from an in vitro PEARLS study
Conclusion: The p-Tm:YAG laser (Dornier Thulio®) demonstrates good ablation efficiency for both COM and UA stones, with no statistically significant differences. This showcases that the p-Tm:YAG is able to efficiently dust stones regardless of stone compositions or laser settings. Future research should focus on comparing the p-Tm:YAG laser with other laser technologies and additional urinary stone types.