Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany.
Curr Opin Urol. 2019 Mar;29(2):103-107. doi: 10.1097/MOU.0000000000000573.
The aim of this study was to summarize the recent innovations of the holmium laser with special respect to lithotripsy. Therefore, we reviewed and discussed the most recent and pivotal publications on this topic.
The current literature underlines Holmium:yttrium-aluminium-garnet (Ho:YAG) lithotripsy as a well tolerated and efficient method to treat urinary calculi. Because of modifiable adjustments of pulse energy, pulse frequency, and pulse length, especially with newer generations of holmium lasers, urologists can accurately choose between the 'fragmentation' and 'dusting' technique with its alterations. Recently, the 'Moses mode' as a new feature incorporated in the Lumenis Pulse P120H holmium laser showed less retropulsion with higher rates of stone ablation because of an improved energy transmission from the laser fiber towards the targeted calculus in in-vitro studies.
Based on technological developments, Ho:YAG laser lithotripsy has become more efficient in reducing retropulsion and increasing stone ablation volume. However, despite its widespread use as a lithotripter, a newly developed thulium fiber laser, which has already shown promising results in experimental studies, could become an alternative in future practice.
本研究旨在总结钬激光碎石术的最新进展。因此，我们对该领域的最新和关键文献进行了回顾和讨论。
目前的文献强调钬：钇-铝-石榴石（Ho:YAG）碎石术是一种安全有效的治疗尿路结石的方法。由于脉冲能量、脉冲频率和脉冲长度的可调节调整，特别是在新一代的钬激光器中，泌尿科医生可以在“碎石”和“粉粹”技术之间进行准确选择，并进行相应的调整。最近，Lumenis Pulse P120H 钬激光中加入的“摩西模式”作为一种新特性，在体外研究中由于激光光纤向靶向结石的能量传输得到改善，显示出较低的后向推力和更高的结石消融率。
基于技术的发展，钬激光碎石术在减少后向推力和增加结石消融体积方面变得更加高效。然而，尽管作为碎石器广泛应用，但一种新开发的铥光纤激光已经在实验研究中显示出良好的效果，可能成为未来实践中的一种替代方法。
