Flexible ureteroscopic treatment of kidney stones: How do the new laser systems change our concepts?
Objective: Flexible ureteroscopy (fURS) has become a widely accepted and effective technique for treating kidney stones. With the development of new laser systems, the fURS approach has evolved significantly. This literature review aims to examine the current state of knowledge on fURS treatment of...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Asian Journal of Urology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388224000195 |
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| author | Simin Yu Linhu Liu Ya Li Liang Zhou Jixiang Chen Hong Li Kunjie Wang |
| author_facet | Simin Yu Linhu Liu Ya Li Liang Zhou Jixiang Chen Hong Li Kunjie Wang |
| author_sort | Simin Yu |
| collection | DOAJ |
| description | Objective: Flexible ureteroscopy (fURS) has become a widely accepted and effective technique for treating kidney stones. With the development of new laser systems, the fURS approach has evolved significantly. This literature review aims to examine the current state of knowledge on fURS treatment of kidney stones, with a particular focus on the impact of the latest laser technologies on clinical outcomes and patient safety. Methods: We conducted a search of the PubMed/PMC, Web of Science Core Collection, Scopus, Embase (Ovid), and Cochrane Databases for all randomized controlled trial articles on laser lithotripsy in September 2023 without time restriction. Results: We found a total of 22 relevant pieces of literature. Holmium laser has been used for intracavitary laser lithotripsy for nearly 30 years and has become the golden standard for the treatment of urinary stones. However, the existing holmium laser cannot completely powder the stone, and the retropulsion of the stone after the laser emission and the thermal damage to the tissue have caused many problems for clinicians. The introduction of thulium fiber laser and Moses technology brings highly efficient dusting lithotripsy effect through laser innovation, limiting pulse energy and broadening pulse frequency. Conclusion: While the holmium:yttrium-aluminum-garnet laser remains the primary choice for endoscopic laser lithotripsy, recent technological advancements hint at a potential new gold standard. Parameter range, retropulsion effect, laser fiber adaptability, and overall system performance demand comprehensive attention. The ablation efficacy of high-pulse-frequency devices relies on precise targeting, which may pose practical challenges. |
| format | Article |
| id | doaj-art-1542a10c437e478e9c85cf770cce90df |
| institution | DOAJ |
| issn | 2214-3882 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj-art-1542a10c437e478e9c85cf770cce90df2025-08-20T02:54:40ZengElsevierAsian Journal of Urology2214-38822024-04-0111215616810.1016/j.ajur.2023.11.001Flexible ureteroscopic treatment of kidney stones: How do the new laser systems change our concepts?Simin Yu0Linhu Liu1Ya Li2Liang Zhou3Jixiang Chen4Hong Li5Kunjie Wang6Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaCorresponding author.; Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaObjective: Flexible ureteroscopy (fURS) has become a widely accepted and effective technique for treating kidney stones. With the development of new laser systems, the fURS approach has evolved significantly. This literature review aims to examine the current state of knowledge on fURS treatment of kidney stones, with a particular focus on the impact of the latest laser technologies on clinical outcomes and patient safety. Methods: We conducted a search of the PubMed/PMC, Web of Science Core Collection, Scopus, Embase (Ovid), and Cochrane Databases for all randomized controlled trial articles on laser lithotripsy in September 2023 without time restriction. Results: We found a total of 22 relevant pieces of literature. Holmium laser has been used for intracavitary laser lithotripsy for nearly 30 years and has become the golden standard for the treatment of urinary stones. However, the existing holmium laser cannot completely powder the stone, and the retropulsion of the stone after the laser emission and the thermal damage to the tissue have caused many problems for clinicians. The introduction of thulium fiber laser and Moses technology brings highly efficient dusting lithotripsy effect through laser innovation, limiting pulse energy and broadening pulse frequency. Conclusion: While the holmium:yttrium-aluminum-garnet laser remains the primary choice for endoscopic laser lithotripsy, recent technological advancements hint at a potential new gold standard. Parameter range, retropulsion effect, laser fiber adaptability, and overall system performance demand comprehensive attention. The ablation efficacy of high-pulse-frequency devices relies on precise targeting, which may pose practical challenges.http://www.sciencedirect.com/science/article/pii/S2214388224000195Laser lithotripsyUrolithiasisThulium laserHolmium:yttrium--aluminum-garnetMoses effect |
| spellingShingle | Simin Yu Linhu Liu Ya Li Liang Zhou Jixiang Chen Hong Li Kunjie Wang Flexible ureteroscopic treatment of kidney stones: How do the new laser systems change our concepts? Asian Journal of Urology Laser lithotripsy Urolithiasis Thulium laser Holmium:yttrium--aluminum-garnet Moses effect |
| title | Flexible ureteroscopic treatment of kidney stones: How do the new laser systems change our concepts? |
| title_full | Flexible ureteroscopic treatment of kidney stones: How do the new laser systems change our concepts? |
| title_fullStr | Flexible ureteroscopic treatment of kidney stones: How do the new laser systems change our concepts? |
| title_full_unstemmed | Flexible ureteroscopic treatment of kidney stones: How do the new laser systems change our concepts? |
| title_short | Flexible ureteroscopic treatment of kidney stones: How do the new laser systems change our concepts? |
| title_sort | flexible ureteroscopic treatment of kidney stones how do the new laser systems change our concepts |
| topic | Laser lithotripsy Urolithiasis Thulium laser Holmium:yttrium--aluminum-garnet Moses effect |
| url | http://www.sciencedirect.com/science/article/pii/S2214388224000195 |
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