University Hospital Southampton NHS Trust, Southampton, UK.
Curr Opin Urol. 2022 Jul 1;32(4):405-410. doi: 10.1097/MOU.0000000000000996. Epub 2022 Jun 9.
Percutaneous nephrolithotomy (PNL) is the mainstay of surgery for renal calculi>2 cm or complex multiple calculi and is a technique that has been around since 1976. We review recent literature surrounding novel lithotripsy devices and technology used in PNL.
At present, the Holmium:yttrium-aluminum-garnet (Ho:YAG) laser is widely accepted as the gold standard laser lithotripsy for PNL. SwissLithoClast Trilogy offers a range of probes with a trifecta of electromagnetic, ultrasonic energy with surgeon-controlled suction. The Olympus Shockpulse-SE is a similar lithotripter that relies on continuous ultrasonic energy with pulsed ballistic energy to break stones. Thulium Fiber Laser (TFL) offers an alternative laser energy source to the Holmium laser, which has been shown to be very effective at producing small stone fragments and dust. The Moses technology is another addition in a long list of improvements to the Ho:YAG laser, forming vaporization bubble through which more effective energy can be applied to stones.
Trilogy, Shockpulse, TFL and Moses pulse modulation technology for the Holmium laser all provide improvements compared with older lithotripsy devices. In particular, they convey a safer, efficient and more effective way to manage and clear stones.
经皮肾镜碎石术（PNL）是治疗>2cm 肾结石或复杂多发性肾结石的主要手段，自 1976 年以来一直沿用至今。我们回顾了最近围绕 PNL 中使用的新型碎石设备和技术的文献。
目前，钬：钇铝石榴石（Ho:YAG）激光被广泛认为是 PNL 的金标准激光碎石术。瑞士 LithoClast Trilogy 提供了一系列探针，具有电磁、超声能量和外科医生控制的抽吸的三重奏。奥林巴斯 Shockpulse-SE 是一种类似的碎石机，依靠连续的超声能量和脉冲弹道能量来碎石。钬光纤激光（TFL）提供了一种替代钬激光的激光能源，已被证明在产生小结石碎片和粉尘方面非常有效。摩西技术是钬：YAG 激光的众多改进之一，它通过形成汽化气泡，可以将更有效的能量应用于结石。
与旧的碎石设备相比，Trilogy、Shockpulse、TFL 和摩西脉冲调制技术为钬激光提供了改进。特别是，它们提供了一种更安全、更高效和更有效的管理和清除结石的方法。
