Initial experience of thulium fiber laser in retrograde intrarenal surgery for ureteral and renal stones in Japan: surgical outcomes and safety assessment compared with holmium: yttrium-aluminum-garnet with MOSES technology

Abstract Background Thulium fiber laser (TFL) has been used for the treatment of ureteral and renal stones in Japan since October 2023. However, there are no reports on the initial results of TFL in Japan. This study aimed to assess the initial results of TFL in retrograde intrarenal surgery (RIRS)...

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Main Authors: Daisuke Kudo, Go Anan, Yoshiharu Okuyama, Taro Kubo, Toshimitsu Matsuoka
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Urology
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Online Access:https://doi.org/10.1186/s12894-025-01738-2
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author Daisuke Kudo
Go Anan
Yoshiharu Okuyama
Taro Kubo
Toshimitsu Matsuoka
author_facet Daisuke Kudo
Go Anan
Yoshiharu Okuyama
Taro Kubo
Toshimitsu Matsuoka
author_sort Daisuke Kudo
collection DOAJ
description Abstract Background Thulium fiber laser (TFL) has been used for the treatment of ureteral and renal stones in Japan since October 2023. However, there are no reports on the initial results of TFL in Japan. This study aimed to assess the initial results of TFL in retrograde intrarenal surgery (RIRS) and to compare them with those of holmium: yttrium-aluminum-garnet (Ho: YAG) laser with MOSES technology. Methods This retrospective single-center study compared perioperative results, complications, and the “stone-free” rate (defined as ≤ 2 mm fragments on computed tomography 1 month after RIRS) between the TFL (60 W) (group A, n = 48) and Ho: YAG laser with MOSES technology (120 W) (group B, n = 48) laser. The inclusion criteria were renal or ureteral stones ≤ 20 mm in diameter and those scheduled for single-stage RIRS. Results The two groups had similar baseline patient characteristics. No significant differences were found in operative time (45 vs. 54 min, P = 0.10), laser time (15 vs. 10 min, P = 0.12), stone-free rate (97.9% vs. 95.8%, P = 1.00), ureteral injury (2.1% vs. 8.3%, P = 0.36), or postoperative fever (0% vs. 4.2%, P = 0.49) between groups A and B. However, significant differences were found in basketing time (7 vs. 21 min, P < 0.01) between groups A and B. Conclusions Our study showed that RIRS with TFL had similar results and no difference in complications compared to RIRS with Ho: YAG laser with MOSES technology. The TFL had a significantly shorter basketing time than the Ho: YAG laser with MOSES technology. Furthermore, future research is needed to determine suitable laser settings for the TFL.
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spelling doaj-art-2786a99ee8e74768abcdfabe7ec67c432025-08-20T02:25:41ZengBMCBMC Urology1471-24902025-04-012511710.1186/s12894-025-01738-2Initial experience of thulium fiber laser in retrograde intrarenal surgery for ureteral and renal stones in Japan: surgical outcomes and safety assessment compared with holmium: yttrium-aluminum-garnet with MOSES technologyDaisuke Kudo0Go Anan1Yoshiharu Okuyama2Taro Kubo3Toshimitsu Matsuoka4Department of Urology, Hachinohe Heiwa HospitalDepartment of Urology, Yotsuya Medical CubeDepartment of Urology, Hachinohe Heiwa HospitalDepartment of Pediatric Urology/ Urology, Tsukuba Memorial HospitalDepartment of Urology, Hachinohe Heiwa HospitalAbstract Background Thulium fiber laser (TFL) has been used for the treatment of ureteral and renal stones in Japan since October 2023. However, there are no reports on the initial results of TFL in Japan. This study aimed to assess the initial results of TFL in retrograde intrarenal surgery (RIRS) and to compare them with those of holmium: yttrium-aluminum-garnet (Ho: YAG) laser with MOSES technology. Methods This retrospective single-center study compared perioperative results, complications, and the “stone-free” rate (defined as ≤ 2 mm fragments on computed tomography 1 month after RIRS) between the TFL (60 W) (group A, n = 48) and Ho: YAG laser with MOSES technology (120 W) (group B, n = 48) laser. The inclusion criteria were renal or ureteral stones ≤ 20 mm in diameter and those scheduled for single-stage RIRS. Results The two groups had similar baseline patient characteristics. No significant differences were found in operative time (45 vs. 54 min, P = 0.10), laser time (15 vs. 10 min, P = 0.12), stone-free rate (97.9% vs. 95.8%, P = 1.00), ureteral injury (2.1% vs. 8.3%, P = 0.36), or postoperative fever (0% vs. 4.2%, P = 0.49) between groups A and B. However, significant differences were found in basketing time (7 vs. 21 min, P < 0.01) between groups A and B. Conclusions Our study showed that RIRS with TFL had similar results and no difference in complications compared to RIRS with Ho: YAG laser with MOSES technology. The TFL had a significantly shorter basketing time than the Ho: YAG laser with MOSES technology. Furthermore, future research is needed to determine suitable laser settings for the TFL.https://doi.org/10.1186/s12894-025-01738-2LaserLithotripsyRetrograde intrarenal surgeryThulium fiber laserUreteral and renal stones
spellingShingle Daisuke Kudo
Go Anan
Yoshiharu Okuyama
Taro Kubo
Toshimitsu Matsuoka
Initial experience of thulium fiber laser in retrograde intrarenal surgery for ureteral and renal stones in Japan: surgical outcomes and safety assessment compared with holmium: yttrium-aluminum-garnet with MOSES technology
BMC Urology
Laser
Lithotripsy
Retrograde intrarenal surgery
Thulium fiber laser
Ureteral and renal stones
title Initial experience of thulium fiber laser in retrograde intrarenal surgery for ureteral and renal stones in Japan: surgical outcomes and safety assessment compared with holmium: yttrium-aluminum-garnet with MOSES technology
title_full Initial experience of thulium fiber laser in retrograde intrarenal surgery for ureteral and renal stones in Japan: surgical outcomes and safety assessment compared with holmium: yttrium-aluminum-garnet with MOSES technology
title_fullStr Initial experience of thulium fiber laser in retrograde intrarenal surgery for ureteral and renal stones in Japan: surgical outcomes and safety assessment compared with holmium: yttrium-aluminum-garnet with MOSES technology
title_full_unstemmed Initial experience of thulium fiber laser in retrograde intrarenal surgery for ureteral and renal stones in Japan: surgical outcomes and safety assessment compared with holmium: yttrium-aluminum-garnet with MOSES technology
title_short Initial experience of thulium fiber laser in retrograde intrarenal surgery for ureteral and renal stones in Japan: surgical outcomes and safety assessment compared with holmium: yttrium-aluminum-garnet with MOSES technology
title_sort initial experience of thulium fiber laser in retrograde intrarenal surgery for ureteral and renal stones in japan surgical outcomes and safety assessment compared with holmium yttrium aluminum garnet with moses technology
topic Laser
Lithotripsy
Retrograde intrarenal surgery
Thulium fiber laser
Ureteral and renal stones
url https://doi.org/10.1186/s12894-025-01738-2
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