Alba Sierra1,2, Mariela Corrales1,2, Merkourios Kolvatzis1,2, Olivier Traxer3,4. 1. Sorbonne University, GRC Urolithiasis No. 20 Tenon Hospital, 75020, Paris, France. 2. Department of Urology AP-HP, Sorbonne University, Tenon Hospital, 75020, Paris, France. 3. Sorbonne University, GRC Urolithiasis No. 20 Tenon Hospital, 75020, Paris, France. olivier.traxer@aphp.fr. 4. Department of Urology AP-HP, Sorbonne University, Tenon Hospital, 75020, Paris, France. olivier.traxer@aphp.fr.
Abstract
OBJECTIVE: To evaluate the new thulium fiber laser (TFL) from Quanta System (Fiber Dust™) in terms of efficiency, safety, and laser settings in laser lithotripsy during retrograde intrarenal surgery (RIRS). METHODS: A prospective study of the first 50 patients with ureteral and renal stones who underwent RIRS using the new Fiber Dust (TFL from Quanta System, Italy) was performed in a single center. 200 µm and 150 µm laser fibers were used. Stone size, stone density, laser-on time (LOT) and laser settings were recorded. We also assessed the ablation speed (mm3/s), Joules/mm3 and laser power (W) values for each procedure. RESULTS: A total of 50 patients were analyzed. The median (IQR) age was 54.5 (43-65) years old. Median (IQR) stone volume was 347 (147-1800) mm3 and 1125 (294-4000) mm3 for ureteral and renal stones, respectively. Median (IQR) stone density was 900 (400-1500) HU for ureteral stones and 950 (725-1125) HU for renal stones. Median (IQR) pulse energy was 0.6 (0.5-1) J and 0.6 (0.5-0.9) J for ureteral and renal stones, respectively. Median (IQR) frequency for ureteral stones was 10 (10-20) Hz and for renal stones, 15 (10-20) Hz. All procedures used short pulse. There were no statistically significant differences in pulse energy, frequency, laser power or LOT in both groups. The median (IQR) J/mm3 was 8.7 (4.8-65.2) for ureteral stones vs 14.3 (7.8-24.7) for renal stones. The median (IQR) ablation rate was 0.3 (0.2-1.3) mm3/s for ureteral stones vs 0.7 (0.4-1.2) mm3/s for renal stones. Neither of those results reached the significance threshold. Overall complication rate was low in both groups, and none was related to TFL. CONCLUSION: According to our results, the new TFL laser is safe and effective for lithotripsy during RIRS, using low pulse energy and low pulse frequency.
OBJECTIVE: To evaluate the new thulium fiber laser (TFL) from Quanta System (Fiber Dust™) in terms of efficiency, safety, and laser settings in laser lithotripsy during retrograde intrarenal surgery (RIRS). METHODS: A prospective study of the first 50 patients with ureteral and renal stones who underwent RIRS using the new Fiber Dust (TFL from Quanta System, Italy) was performed in a single center. 200 µm and 150 µm laser fibers were used. Stone size, stone density, laser-on time (LOT) and laser settings were recorded. We also assessed the ablation speed (mm3/s), Joules/mm3 and laser power (W) values for each procedure. RESULTS: A total of 50 patients were analyzed. The median (IQR) age was 54.5 (43-65) years old. Median (IQR) stone volume was 347 (147-1800) mm3 and 1125 (294-4000) mm3 for ureteral and renal stones, respectively. Median (IQR) stone density was 900 (400-1500) HU for ureteral stones and 950 (725-1125) HU for renal stones. Median (IQR) pulse energy was 0.6 (0.5-1) J and 0.6 (0.5-0.9) J for ureteral and renal stones, respectively. Median (IQR) frequency for ureteral stones was 10 (10-20) Hz and for renal stones, 15 (10-20) Hz. All procedures used short pulse. There were no statistically significant differences in pulse energy, frequency, laser power or LOT in both groups. The median (IQR) J/mm3 was 8.7 (4.8-65.2) for ureteral stones vs 14.3 (7.8-24.7) for renal stones. The median (IQR) ablation rate was 0.3 (0.2-1.3) mm3/s for ureteral stones vs 0.7 (0.4-1.2) mm3/s for renal stones. Neither of those results reached the significance threshold. Overall complication rate was low in both groups, and none was related to TFL. CONCLUSION: According to our results, the new TFL laser is safe and effective for lithotripsy during RIRS, using low pulse energy and low pulse frequency.