What to expect from the novel pulsed thulium:YAG laser? A systematic review of endourological applications

Introduction Several preclinical studies about a novel pulsed-thulium:yttrium-aluminum-garnet (p-Tm:YAG) device have been published, demonstrating its possible clinical relevance. Methods We systematically reviewed the reality and expectations for this new p-Tm:YAG technology. A PubMed, Scopus and E...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:World journal of urology 2023-11, Vol.41 (11), p.3301-3308
Hauptverfasser: Ventimiglia, Eugenio, Robesti, Daniele, Bevilacqua, Luigi, Tondelli, Elena, Oliva, Isabella, Orecchia, Luca, Juliebø-Jones, Patrick, Pietropaolo, Amelia, De Coninck, Vincent, Esperto, Francesco, Tailly, Thomas, Ferretti, Stefania, Gauhar, Vineet, Somani, Bhaskar, Villa, Luca, Keller, Etienne Xavier, Salonia, Andrea, Traxer, Olivier, Kartalas Goumas, Ioannis
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Introduction Several preclinical studies about a novel pulsed-thulium:yttrium-aluminum-garnet (p-Tm:YAG) device have been published, demonstrating its possible clinical relevance. Methods We systematically reviewed the reality and expectations for this new p-Tm:YAG technology. A PubMed, Scopus and Embase search were performed. All relevant studies and data identified in the bibliographic search were selected, categorized, and summarized. Results Tm:YAG is a solid state diode-pumped laser that emits at a wavelength of 2013 nm, in the infrared spectrum. Despite being close to the Ho:YAG emission wavelength (2120 nm), Tm:YAG is much closer to the water absorption peak and has higher absorption coefficient in liquid water. At present, there very few evaluations of the commercially available p-Tm:YAG devices. There is a lack of information on how the technical aspects, functionality and pulse mechanism can be maximized for clinical utility. Available preclinical studies suggest that p-Tm:YAG laser may potentially increase the ablated stone weight as compared to Ho:YAG under specific condition and similar laser parameters, showing lower retropulsion as well. Regarding laser safety, a preclinical study observed similar absolute temperature and cumulative equivalent minutes at 43° C as compared to Ho:YAG. Finally, laser-associated soft-tissue damage was assessed at histological level, showing similar extent of alterations due to coagulation and necrosis when compared with the other clinically relevant lasers. Conclusions The p-Tm:YAG appears to be a potential alternative to the Ho:YAG and TFL according to these preliminary laboratory data. Due to its novelty, further studies are needed to broaden our understanding of its functioning and clinical applicability.
ISSN:1433-8726
0724-4983
1433-8726
DOI:10.1007/s00345-023-04580-z