Ashraf Yasir, Ali Suliman, Zamzami Muhannad, Abedin Asad
Department of Urology, University College London, London, GBR.
Department of Otolaryngology, Leicester Royal Infirmary, Leicester, GBR.
Cureus. 2025 Aug 3;17(8):e89298. doi: 10.7759/cureus.89298. eCollection 2025 Aug.
Next-generation Moses™ technology is a pulse modulation modality of the traditional holmium yttrium-aluminum-garnet (YAG) laser and has been developed for use in both laser lithotripsy and prostate enucleation. In traditional holmium YAG lasers, the energy is delivered in a single continuous pulse, which can be less efficient in terms of stone fragmentation and tissue interaction. Moses technology, on the other hand, uses multiple, shorter pulses within a single laser firing cycle, which makes the energy delivery more controlled and effective. In pre-clinical studies, Moses™ technology has been shown to improve stone fragmentation efficiency in lithotripsy and reduce overall procedure time in prostate enucleation. Given its relatively recent introduction, it is still unclear if use of Moses™ can translate to efficiency and time savings in the operating room. The aim of this narrative review is to summarise the latest evidence for use of Moses™ technology in the treatment of urolithiasis and prostate enucleation. To compare Moses™ to standard holmium, a literature review was conducted in PubMed and Embase for randomised controlled trials and cohort studies. For laser lithotripsy, outcomes investigated were overall procedure time, fragmentation time, degree of retropulsion, stone-free rate and complications. For prostate enucleation, the outcomes were operative time and haemostasis time. This review summarises current comparative findings between Moses™ and conventional holmium:YAG laser in the context of lithotripsy and prostate enucleation, highlighting consistent advantages in key operative metrics across both applications. Current literature evidence suggests Moses™ technology is associated with superior outcomes compared to standard holmium YAG laser in several key parameters determining the overall efficiency. For urolithiasis, Moses™ could offer shorter procedure times and for prostate enucleation, it could reduce the learning curve of HoLEP, enabling it to become an outpatient-based procedure.
下一代摩西™技术是传统钬钇铝石榴石（YAG）激光的一种脉冲调制模式，已被开发用于激光碎石术和前列腺剜除术。在传统的钬YAG激光中，能量以单个连续脉冲的形式传递，在结石破碎和组织相互作用方面可能效率较低。另一方面，摩西技术在单个激光发射周期内使用多个更短的脉冲，这使得能量传递更可控且更有效。在临床前研究中，摩西™技术已被证明可提高碎石术中的结石破碎效率，并减少前列腺剜除术的总体手术时间。鉴于其引入时间相对较近，目前尚不清楚使用摩西™技术是否能在手术室中转化为效率提升和时间节省。本叙述性综述的目的是总结摩西™技术在治疗尿石症和前列腺剜除术中应用的最新证据。为了将摩西™技术与标准钬激光进行比较，在PubMed和Embase上进行了文献综述，以查找随机对照试验和队列研究。对于激光碎石术，研究的结果包括总体手术时间、破碎时间、后推程度、结石清除率和并发症。对于前列腺剜除术，结果包括手术时间和止血时间。本综述总结了摩西™技术与传统钬：YAG激光在碎石术和前列腺剜除术方面的当前比较结果，突出了在这两种应用的关键手术指标上的一致优势。当前文献证据表明，在决定总体效率的几个关键参数方面，与标准钬YAG激光相比，摩西™技术具有更好的效果。对于尿石症，摩西™技术可以缩短手术时间；对于前列腺剜除术，它可以缩短钬激光前列腺剜除术（HoLEP）的学习曲线，使其能够成为一种门诊手术。
