Purpose To evaluate whether stone dust can be obtained from all prevailing stone composition types using the thulium fiber laser (TFL) for lithotripsy. The thulium fiber laser (TFL), which couples higher power with smaller fibers than are typically used with the holmium laser, is being evaluated as an alternative to the Ho:YAG laser. During each trial, a 200-μm thulium laser fiber was introduced through the working channel of the ureteroscope. The pulsed infrared light emitted by the TFL has a wavelength of 1940 nm that is close to the water absorption peak. The TFL is more ideally suited for laser lithotripsy because of the higher absorption coefficient of the emitted wavelength in water, the superior Gaussian profile of the laser beam, and the ability to operate at arbitrary temporal pulse . Olympus Launches the Soltive SuperPulsed Thulium Fiber ... By Regions/Countries: North America United States Canada Mexico. Current status of thulium fibre laser lithotripsy: an up ... Detachable fiber optic tips for use in thulium fiber laser ... UCI Health urologists have tested a new laser technology that can reduce even large kidney stones to dust, which can be easily suctioned or flushed from the body.The super-pulsed thulium fiber laser is "a game-changer," says Ralph V. Clayman, MD, distinguished professor of urology and dean emeritus of the UCI School of Medicine. Preclinical comparison of superpulse thulium fiber laser ... The holmium laser (λ=2120 nm) was operated with standard parameters of 600 mJ, 350 μs, 6 Hz, and 270-μm-core optical fiber. in English, Spanish The SuperPulsed Thulium fiber laser has recently become available to the urologist. Temperature Rise during Laser Lithotripsy: Comparison of Super Pulse Thulium Fiber LASER (SPTF) vs High Power 120W Holmium-YAG LASER (Ho:YAG) Molina, W., et al. Mechanism of Lithotripsy by Superpulse Thulium Fiber Laser ... However, recent reports about a new prototype thulium fiber laser (TFL) lithotripter have revealed impressive levels of performance. SOLTIVE™ SuperPulsed Laser System | Olympus America | Medical Especially holmium and thulium lasers offer advanced performance with a lower intraoperative bleeding risk and . The laser fiber tip was extended 10 mm such that it resided in the center of the calix away from both the URS thermocouple, the caliceal wall, and the MTS probe. This versatility is achieved by combining a pulsed Holmium laser with a continuous wave Thulium laser in a single laser unit. Thulium fiber laser energy of 70-mJ delivered at 20 Hz through a 100 μm fiber resulted in vaporization and fragmentation rates of 10 and 60 mg/min for uric acid stones. April 13, 2020. This study exploits the Thulium fiber laser (λ = 1908 nm) beam profile for higher power transmission through . Both problems are related to fiber diameter and limited by the Holmium:YAG laser (λ = 2120 nm) multimode beam profile. Multiple diode lasers are pumping energy through the fiber and excite the thulium ions. The goal of this study was to compare stone fragmentation and dusting performance of the prototype superpulse thulium fiber laser with leading commercially available, high-power holmium:YAG lithotripters (wavelength 2100 nm) in a controlled in . Introduction The Thulium fiber laser overcomes the main limitations reported with the Holmium:YAG laser relating to lithotripsy, based on preliminary in vitro studies. Lisette Hilton. Where applicable, stone dust was further characterized by morpho-constitutional analysis. The thulium fiber laser (TFL) has recently arisen as an alternative to the current gold standard for stone lithotripsy—the holmium (Ho:YAG) laser. TFL parameters differ in several fundamental ways from Holmium laser, including smaller fiber delivery, more strongly absorbed wavelength, low pulse energy/high pulse rate operation, and more uniform temporal pulse structure. Holmium:YAG laser lithotripsy via advanced ureteroscopy has become a major technique for minimally invasive destruction of urinary stones. It can be safely and efficiently applied to humans for the purposes of laser lithotripsy. Wilson CR, Hardy LA, Irby PB, Fried NM. U.S. academic centers using the Soltive SuperPulsed Laser System to treat stones are finding it offers several advantages compared with holmium:YAG laser lithotripsy. MasterPULSE Research Article Keywords Thulium fiber laser, Covid-19 patients, Lithotripsy, Urolithiasis. Fiber Dust. The Thulium Fiber Laser (TFL) has been studied as a potential alternative to the conventional Holmium:YAG laser (Ho:YAG) for the treatment of kidney stones. . At low pulse energy, it achieves effective stone dusting. Though the They can be coupled with lasers intended for general use in lithotripsy, BPH, and soft tissue surgery. Here we describe in a clinical-friendly way the concepts of peak power and pulse modulation for laser lithotripsy, analyzing both TFL and Ho:YAG lasers. Many claims of better performance in comparison to the Holmium:Yttrium-Aluminum-garnet (Ho:YAG) laser, the current gold-standard in endoscopic laser lithotripsy have been made in several papers, congress presentations or scientific news outlets . We prospectively analyzed 40 patients who underwent Super-Pulse Tm fiber laser lithotripsy for renal (n=29), ureteral (n=9), and bladder stones (n=2) with various laser settings. 3.2. Abstract The thulium fiber laser (TFL) is being explored as an alternative laser lithotripter to the standard holmium:yttrium-aluminum-garnet laser. The aim of the study is to compare URS lithotripsy performed with Holmium:YAG laser and Thulium Fiber Laser. LA Hardy, CR Wilson, PB Irby, NM Fried. Conclusion: Using the Thulium laser technology allows for a quick and safe alternative to Holmium for fragmenting ureteric stones with a high stone-free rate. With further development, the thulium fiber laser may represent an alternative to the conventional holmium laser for more efficient laser lithotripsy. Size of the stone, its density, operation time, "laser on" time were measured. Intraoperative aspects of Soltive lithotripsy of a large renal stone (2.5/1.7 cm) disintegrated with this new Thulium fiber laser system. Evidence acquisition Lasers Surg Med. With a shorter optical penetration depth in water and a higher absorption coefficient, its ablation threshold is 4 times lower than that of the holmium laser . RIRS Vs MINIPERC 2019 HyderabadOrganised by :PREETI UROLOGY AND KIDNEY HOSPITALKukatpally -- Lingampally UA and COM stone vaporization rates for the thulium fiber laser averaged 5-10 times higher than for the holmium laser at 70 mJ pulse energies. Rapid Thulium Fiber Laser Lithotripsy at Pulse Rates up to 500 Hz Using a Stone Basket. Thulium fiber laser with a wavelength of 1.94 µm is widely used in urology for lithotripsy. Thulium fiber laser technology | Cook Medical Master the TFL experience and advance your procedures. However, this mature technology has some fundamental limitations. The thulium fiber laser (TFL) is currently being studied as an alternative to the conventional holmium:YAG (Ho:YAG) laser for lithotripsy. From this initial experience, we conclude that the SuperPulse Thulium fiber laser is applicable for lithotripsy of large renal stones in humans. Photons are emitted at 1940 nm wavelength and directed at the operational field via an outgoing laser fiber. The energy is, therefore, highly absorbed by water. As applications for thulium fiber lasers such as laser lithotripsy, clear plastic welding, and IR countermeasures continue to be developed, leading manufacturers are choosing nLIGHT 793nm semiconductor lasers as their pump source. Thulium fiber laser utilization in urology The thulium fiber laser (TFL) is a novel laser type which has shown early promise and may offer several advan-tages over Ho:YAG lasers. INTRODUCTION. By Application Hospitals Clinics Others. Indeed, in a prior review, Traxer and Keller [6] evaluated the early literature on TFLs and potential advantages in experimental models. We therefore decided to systematically review the reality and expectations for this new TFL technology. 1.2. The Fiber Dust features the latest laser technologies from Quanta System. SuperPulse Thulium Fiber Laser Urolase SP+ (60W) IPG Photonics is a leading Surgical Thulium Fiber laser solutions provider for urology, as well as a range of other surgical specialties including General Surgery, gastroenterology, pulmonology, orthopaedics, and more. The thulium fibre laser (TFL) is the latest laser technology, which has gained increased attention for its role in stone lithotripsy since its application for this purpose was first described in 2005 as part of an in vitro study [ 9 ]. Use MasterPULSE in the pulsed mode to tune the effect of laser emission based on your visual feedback to change lithotripsy effect and tissue cutting. Int J Urol. N≥5 samples for each data set. Many claims of better performance in comparison to the Holmium:Yttrium-Aluminum-garnet (Ho:YAG) laser, the current gold-standard in endoscopic laser lithotripsy have been made in several papers, congress presentations or scientific news outlets . Selected Topics in Quantum Electronics 20 (5), 2014. UA and COM stone vaporization rates for Thulium fiber laser averaged 5-10 times higher than for Holmium laser at 70 mJ pulse energies. [ PubMed ] [ Google Scholar ] The TFL has several potential advantages compared to Ho:YAG laser for lithotripsy, including a four times lower ablation threshold, a near single-mode beam profile, and higher pulse rates . Thulium fiber laser with a wavelength of 1.94 µm is widely used in urology for lithotripsy. INTRODUCTION. Recent advances in both Holmium and TFL technology allow operation at similar laser parameters for direct comparison. A continuous-wave, high-power Thulium fiber laser operating at a wavelength of 1.94 µm, was modulated to operate in pulsed mode with an output pulse energy of 1 J through a 300-µm-core silica fiber at a 20 milliseconds pulse length and repetition rate of 10 Hz. 15, 16 One TFL advantage is that the light originates within a small (18- to 25-μ m core) thulium-doped silica fiber, so the emitted light can be coupled into smaller (50-, 100-, or 150-μ m . 2. Lithotripsy was performed with a SuperPulsed thulium-fiber laser (NTO IRE-Polus, Fryazino, Russia) using a rigid ureteroscope 7.5 Ch (Richard Wolf, Knittlingen, Germany). A systematic review was developed using the PubMed, ScienceDirect, Wiley, SpringerLink and Mary Ann Liebert Scopus databases between 2012 and 2020 years, using the PRISMA statement. Moreover, the recent market introduction of the thulium fiber laser (TFL) makes it compelling for urologists to become familiar with this new technology. Recently, a new thulium fiber laser (TFL) has been introduced. Introduction The prevalence of kidney stone disease has increased in the modern Laser technology is widely used in urological surgery, from lithotripsy, prostate surgery to en-bloc resection of tumours. Introduction: Thulium Fiber Laser (TFL) is the latest laser technology, which has gained increased attention for its role in stone lithotripsy. [Google Scholar] The Thulium fiber laser (TFL) is being explored as an alternative to the Holmium : YAG laser for lithotripsy. The Thulium fiber laser has recently been tested as a potential alternative to the Holmium:YAG laser for lithotripsy. Super Pulse Thulium Fiber Laser Compared to 120W Holmium:YAG Laser: Impact on Retropulsion and Laser Fiber Burn Back Knudsen, B., et al. This paper studies the mechanism of lithotripsy and evaluates its clinical efficiency using the superpulse thulium fiber laser with a wavelength of 1.94 µm and a peak power of 500 W. An experimental setup was developed to study the mechanism of lithotripsy. By Type Holmium-YAG Laser Lithotripsy Thulium Fiber Laser Lithotripsy Others. The more uniform beam profile of the TFL enables higher power transmission through smaller fibers. Endoscopic lithotripsy with a SuperPulsed thulium-fiber laser for ureteral stones: a single-center experience. Request PDF | Superpulse thulium fiber laser lithotripsy: an in vitro comparison of 200 μm and 150 μm laser fibers | PurposeTo investigate the thermal effects, stone retropulsion and ablation . With further development, the Thulium fiber laser may represent an alternative to the conventional Holmium laser for more efficient laser lithotripsy. Materials & Methods: Patients with stones < 30 mm were prospectively recruited to undergo PCNL using . The TFL is more ideally suited for laser lithotripsy because of the higher absorption coefficient of the emitted wavelength in water, the superior Gaussian profile of the laser beam, and the ability to operate at arbitrary temporal pulse . The diode-pumped TFL may be electronically modulated to operate with variable arameters (e.g., pulse rate, pulse duration, and duty cycle) for studying the influence of pulse train mode on stone blation rates. The Thulium Fiber Laser (TFL) has been studied as a potential alternative to the conventional Holmium:YAG laser (Ho:YAG) for the treatment of kidney stones. Especially holmium and thulium lasers offer advanced performance with a lower intraoperative bleeding risk and . The potential clinical advantages of TFL compared to the Ho:YAG laser arise from differences in laser beam generation. Thulium Fiber Laser Pumping. th World . This innovative laser technology seems particularly advantageous for ureteroscopy and may become an important milestone for kidney stone treatment. SuperPulse Thulium Fiber Laser Urolase SP+ (60W) IPG Photonics is a leading Surgical Thulium Fiber laser solutions provider for urology, as well as a range of other surgical specialties including General Surgery, gastroenterology, pulmonology, orthopaedics, and more. The Thulium fiber laser beam profile provides higher laser power through smaller fibers than the Ho:YAG laser, potentially reducing fiber failure and endoscope damage and . Journal of Endourology, 2019 7. of Thulium fiber laser (TFL) in laser lithotripsy during percutaneous nephrolithotomy (PCNL). Methods Human urinary stones were submitted to in vitro lithotripsy using a FiberLase U2 TFL generator with 150 µm silica core fibers (IPG Photonics . Kuntz RM, Lehrich K, Ahyai SA. Using a validated in vitro ureter model for laser lithotripsy, the performance of an experimental thulium fiber laser (TFL) was studied and compared to the clinical gold standard holmium:YAG laser. Abstract: The Holmium:yttrium-aluminum-garnet (Ho:YAG) laser has been the gold-standard for laser lithotripsy over the last 20 years. Fiber Dust Thulium Fiber Laser (TFL) is designed for fine dusting of stones at one of the highest frequencies (up to 2500 Hz) with pulse energy from 0.02 J to 6 J. SuperPulsed thulium fiber laser shows several advantages. The flashlamp-pumped solid-state Holmium:YAG laser has been the dominant technology in laser lithotripsy for over the past two decades. center valley, pa., (june 17, 2020) - olympus®, a global technology leader in designing and delivering innovative solutions for medical and surgical procedures, announces the commercial launch of the soltive™ superpulsed laser system (soltive laser system), a new application of thulium fiber laser technology designed for stone lithotripsy and … 1,2 A prominent advantage of fiber laser is the ability to transmit high-power energy through a small-sized fiber to increase energy density of irradiation. The goal of this study was to compare stone fragmentation and dusting performance of the prototype superpulse thulium fiber laser with leading commercially available, high-power holmium:YAG lithotripters (wavelength 2100 nm) in a controlled in . Based on surgeon's feedback, retropulsion and intraoperative visibility were assessed. The continuous progress in surgical lasers with fiber optics, combined with the widespread use of miniaturized endoscopic instruments able to go where a hand or scalpel could never reach, makes laser surgery the best support for the urologist and for the development of endourology.. Hardy LA, Wilson CR, Irby PB, Fried NM (2014) Thulium fiber laser lithotripsy in an in vitro ureter model. The experimental thulium fiber laser (TFL) has recently been studied as an alternative laser lithotripter to the clinical Ho:YAG laser for several reasons. To evaluate the efficacy and safety of thulium-fiber laser (TFL) in laser lithotripsy during percutaneous nephrolithotomy (PCNL). 27. Purpose To evaluate whether stone dust can be obtained from all prevailing stone composition types using the thulium fiber laser (TFL) for lithotripsy. But more research comparing the two is needed, according to a presentation at the 2019 . RevoLix DUO is the first and only universal laser in urology for lithotripsy, BPH, endoscopic, laparoscopic and open surgery. Future studies are warranted to define optimal lithotripsy settings and further detail safety profile of the SuperPulse Thulium fiber laser. Standard Fiber. The continuous progress in surgical lasers with fiber optics, combined with the widespread use of miniaturized endoscopic instruments able to go where a hand or scalpel could never reach, makes laser surgery the best support for the urologist and for the development of endourology.. J Biomed Opt 16(7):071403. {1908}$ nm) beam profile for higher power transmission through smaller fibers. Fiber Tip Degradation Studies Lasers Surg Med. 48: 2014: Thulium fiber laser ablation of kidney stones using a 50- . Complications during laser lithotripsy include optical fiber bending failure resulting in endoscope damage and low irrigation rates leading to poor visibility. 2020. Blackmon RL, Irby PB, Fried NM (2011) Comparison of holmium:YAG and thulium fiber laser lithotripsy: ablation thresholds, ablation rates, and retropulsion effects. Article Google Scholar 18. Thulium fiber laser (TFL) is becoming a new player in the field of lithotripsy in urology. In the last few years, many rumours and hype has surrounded a new laser technology, the thulium fibre laser (TFL). To evaluate emerging evidence and practical applications of thulium-fiber laser (TFL) for genitourinary soft tissue disease and urinary stone disease treatment. 2015; 47:403-410. doi: 10.1002/lsm.22348. Mean ablation rates (μg/s) for thulium fiber laser lithotripsy as a function of stone type and pulse delivery mode.a a The pulse energy was 35 mJ, pulse duration was 500 μs, fiber diameter was 100 μm, and total number of pulses was 6,000. This paper studies the mechanism of lithotripsy and evaluates its clinical efficiency using the superpulse thulium fiber laser with a wavelength of 1.94 µm and a peak power of 500 W. An experimental setup was developed to study the mechanism of lithotripsy. Thulium fiber laser radiation with 1 ms pulse duration, pulse rates of 1030 Hz, and 70-$\mu$ m-diameter . The thulium fiber laser (TFL) is currently being explored as an alternative laser source to that of the conventional holmium:YAG laser for lithotripsy. 6 - 11 First, the TFL has a higher absorption coefficient (160 cm − 1) and shorter optical penetration depth in water, which in part translates into a four-time lower ablation threshold for the TFL . In the last few years, many rumours and hype has surrounded a new laser technology, the thulium fibre laser (TFL). Unique Combined Thulium/ Holmium Laser - for BPH and Stones. Fibers are compatible across Quanta's holmium and thulium laser systems. The experimental Thulium fiber laser (TFL) is currently being studied as a potential alternative to the gold standard Holmium:YAG laser for lithotripsy. 2005; 37 (1):53-58. The Soltive Laser System is 510(k) cleared by the U.S. FDA and CE (Conformité Européene) Mark approved by the responsible European Notified Body, We analyzed the efficacy of lithotripsy by measuring total energy required for stone disintegration, "laser-on" time, ablation speed, ablation efficacy, and energy consumption. On the contrary, the thulium fiber laser (TFL) is limited to low pulse energies, but can operate efficiently at high pulse rates (up to 1000 Hz). The study is designed as a prospective clinical randomised trial, where the study participants are randomised to either URS with Holmium:YAG laser or URS with Thulium Fiber Laser. Thulium fiber laser lithotripsy setup. Purpose: A superpulse (500 W peak power) thulium fiber laser operating at a 1940 nm wavelength, suitable for lithotripsy, has recently been developed. Collateral damage to the ureter and Nitinol stone baskets during thulium fiber laser lithotripsy. Methods Human urinary stones were submitted to in vitro lithotripsy using a FiberLase U2 TFL generator with 150 µm silica core fibers (IPG Photonics . Specifically, the thulium fiber laser (TFL) offers a higher laser energy absorption in water and has been reported to cause minimal stone retropulsion in vitro [ 4 ]. While Holmium:YAG has been widely employed over the last two decades, in recent years, there has been a surge of interest in Thulium Fiber Laser (TFL), which offers theoretical advantages of better water absorption and lower stone ablation thresholds. The holmium:YAG (Ho:YAG) laser lithotriptor is capable of operating at high pulse energies, but efficient operation is limited to low pulse rates (∼10 Hz) during lithotripsy. A review of thulium-fiber laser in stone lithotripsy and soft tissue surgery The introduction of pulsed TFL technology has enabled the ablation of stones at rates comparable to or better than currently existing lasers in vitro, while also potentially reducing stone retropulsion. East Asia . "It targets the water in the stones and can rapidly reduce . Thulium fiber laser (TFL) uses long, thin and thulium-doped silica fiber as the active laser medium. We used a single-use digital flexible ureteroscope (Pusen PU 3022A) and the Sony 55-inch monitor (double-checked image with the original Pusen monitor). Standard fibers feature a bare (flat) tip for frontal laser emission. Thulium fiber laser lithotripsy: an in vitro analysis of stone fragmentation using a modulated 110-watt thulium fiber laser at 1.94 microm. Purpose A superpulse (500 W peak power) thulium fiber laser operating at a 1940 nm wavelength, suitable for lithotripsy, has recently been developed. Methods: Stone size, stone density, operative time, and "laser on" time (LOT) were recorded. This study explores use of a short taper for expanding the Thulium fiber laser beam at the distal tip of a small-core fiber. Thulium Fiber-Laser Lithotripsy. Enikeev D, Grigoryan V, Fokin I, et al. Findings from in vitro studies have shown that it can. Olympus, a global technology leader in designing and delivering innovative solutions for medical and surgical procedures, announces the commercial launch of the Soltive™ SuperPulsed Laser System (Soltive Laser System), a new application of thulium fiber laser technology designed for stone lithotripsy and soft tissue applications. Study included only cases managed with fragmentation. Super Pulse Thulium Fiber Laser Compared to 120W Holmium:YAG Laser: Impact on Retropulsion and Laser Fiber Burn Back: Dr. Bodo Knudsen: Accepted: WCE 2019: Temperature rise during Laser Lithotripsy: Comparison of Super Pulse Thulium Fiber LASER (SPTF) vs High Power 120W Holmium-YAG LASER (Ho:YAG) Dr. Wilson Molina: Accepted: WCE 2019 launch of the Soltive™ SuperPulsed Laser System (Soltive Laser System), a new application of thulium fiber laser technology designed for stone lithotripsy and soft tissue applications. The experimental thulium fiber laser (TFL) is being studied as a potential alternative to the holmium:YAG (Ho:YAG) laser for the treatment of kidney stones. The TFL (λ=1908 nm) was operated with 35 mJ, 500 μs, 150 to 500 Hz . Where applicable, stone dust was further characterized by morpho-constitutional analysis. Choose between single-use and reusable options. The Soltive Laser System is 510(k) cleared by the U.S. FDA and . In this study, a 100-μm core, 140-μm outer-diameter (OD) silica fiber with 5-mm length hollow steel tip was integrated with 1.3F (0.433-mm OD . Complications during laser lithotripsy include optical fiber bending failure resulting in endoscope damage and low irrigation rates leading to poor visibility. Alternative technologies, such as Thulium Fiber lasers, Thulium:YAG lasers and Erbium:YAG lasers, have also been explored for laser lithotripsy. nLIGHT's proven reliability of the element product family across industrial and medical industries demonstrates a platform that can be . 3 TFL belongs to the family of infrared laser as well as holmium:yttrium-aluminum-garnet (Ho . : a single-center experience, therefore, highly absorbed by water potential clinical advantages of compared... A small-core fiber it achieves effective stone dusting Irby PB, Fried nm ( 2014 ) Thulium laser... 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