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</html>";s:4:"text";s:35076:"A new tool for kidney stone ablation demonstrates strong potential to dust and fragment stones more quickly and efficiently than devices currently available in the United States. PDF | On Jan 1, 2020, M.E. On the contrary, the Thulium Fiber Laser (TFL) is limited to low pulse energies, but can operate at very high pulse rates (up to 1000 Hz). At the BPH workstation, the […] On the contrary, the Thulium Fiber Laser (TFL) is limited to low pulse energies, but can operate at very high pulse rates (up to 1000 Hz). What is RevoLix Thulium Laser for BPH? SuperPulsed thulium fiber laser shows several advantages. It is a systemic review based on a comprehensive search of PubMed, Cochrane, and Google scholar databases from inception to 31 March 2020. The pulse frequency is within 50 Hz, and average power delivered to the stone is 2-100 W. This depends on the size of the stone . Recently, the thulium fiber laser has been introduced for medical use. The experimental Thulium fiber laser (TFL) is currently being studied as a potential alternative to the gold standard Holmium:YAG laser for lithotripsy. They can be coupled with lasers intended for general use in lithotripsy, BPH, and soft tissue surgery. penetration depth of 0.4 mm for holmium and of 0.25 mm for thulium laser. Purpose The holmium-YAG (Ho:YAG) Laser system is the current gold standard for laser lithotripsy (LL). The thulium fiber laser (TFL) is a novel technology under active investigation as an conceivable alternative to the Holmium:yttrium- aluminum-garnet (Ho:YAG) laser, which is currently the gold standard for an array of urologic procedures. 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. WCE 2018. Standard fibers feature a bare (flat) tip for frontal laser emission. 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. Holmium laser prostate surgery is a minimally invasive treatment for an enlarged prostate. The high-temperature water absorption coefficient for the Thulium wavelength (μ&lt;sub&gt;a&lt;/sub&gt; = 160 cm&lt;sup&gt;-1&lt;/sup&gt; at λ = 1908 nm) is significantly greater than for the Holmium . The RevoLix laser wavelength is 2 micron. This versatility is achieved by combining a pulsed Holmium and a continuous wave (cw) Thulium laser in one laser head. Methods A total of 116 consecutive patients with BPH were randomized to be treated surgically with either HoLEP (n = 58) or ThuLEP (n = 58 . : Temperature rise during ureteral laser lithotripsy: comparison of superpulse thulium fiber laser (SPTF) vs. high-power 120 W holmium-YAG laser (Ho:YAG) Mark Taratkin 1 , Thomas R. W. Herrmann 2 , 3 &amp; Additionally, currently available literature on Thulium fiber laser lithotripsy is reviewed. Comparison of Rapid-Pulse Tm Fiber LASER (RPFL) vs. High-Power 120 W Holmium YAG LASER (Ho:YAG): Stone Ablation Efficiency at the Same Average Power Settings. 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). Both the Thulium fiber laser and Holmium:YAG lasers are capable of vaporizing prostate tissue at a rate &gt; 1 g/min if operated at the high powers (100-W) typically used in the clinic. Lumenis MOSES Pulse 120H all-in-one laser urology platform. 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. These differences may be attributed to the measuring device. Thulium fiber laser technology explained. The Holmium:YAG (Ho:YAG) laser lithotriptor is capable of operating at high pulse energies, but its efficient operation is limited to relatively low pulse rates (∼10 Hz) during lithotripsy. This laser has been cleared for the treatment of stones and soft tissue. Super Pulse Thulium Fiber Laser (SPTF) has emerged as an effective alternative. January 27, 2020. The Holmium:YAG laser is currently the most common laser lithotripter. 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 main difference for ThuLEP though is that the enucleation of the adenoma is done mechanically, without any laser energy. Med. Thulum laser has a wavelength of 2 um, which is nearing the absorption peak of water, therefore it has the most efficient vaporization . Another advantage of thulium laser is its shallowest penetration depth compared to holmium and green-light laser , which allows more accurate resection and might reduce the risk of bladder perforation. 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. It was . The thulium:YAG laser resulted in lower blood loss statistically compared with the holmium:YAG laser (130.1 vs 166.6 mL, respectively). Holmium laser enucleation of the prostate versus thulium laser enucleation of the prostate for the treatment of large-volume prostates &gt; 80 ml: 18-month follow-up results World J Urol , 38 ( 2020 ) , pp. Lithotripsy in the lower, medial and upper tract with rigid and flexible instruments is accomplished by the integrated Holmium laser. Operation is in the pulsed mode for lithotripsy applications. Thulium is superior to holmium laser in. SOLTIVE™ SuperPulsed Laser is powered by a novel energy source for striking performance compared to conventional Holmium YAG1 Capable of dusting stones in half the time and fragmenting stones relentlessly - with virtually no retropulsion2. The common pulse durations range from 250 to 350 us, and pulse energies in 0.2-5 J/pulse. The Thulium fiber laser overcomes the main limitations reported with the Holmium:YAG laser relating to lithotripsy, based on preliminary in vitro studies. Thulium fiber laser (TFL) uses long, thin and thulium-doped silica fiber as the active laser medium. The SOLTIVE Laser system is a compact system which is significantly smaller than Holmium laser systems. With the Holmium laser at 1.0 J, we obtained values of 7.5 N in the contact setup and 10.9 N in 3 mm distance, which is 6-9 times higher than the reported findings at 0.6 J. This wavelength is absorbed in any tissue by the ubiquitous water molecule. Holmium Laser Enucleation of the Prostate (HoLEP) is a safe and effective BPH treatment option for prostates of all sizes11-15. The most versatile and powerful platform for the treatment of a variety of urological disorders. Context: Thulium LASER is fast emerging as a safe and effective modality for benign prostatic hyperplasia (BPH). With the Holmium laser at 1.0 J, we obtained values of 7.5 N in the contact setup and 10.9 N in 3 mm distance, which is 6-9 times higher than the reported findings at 0.6 J. 1 Zhang et al. Stable Q-switched . Holmium laser is used for both procedures. Purpose: To compare a novel Thulium laser device with the commonly used Holmium:Yttrium-Aluminum-Garnet (Ho:YAG) laser in terms of the in vitro temperatures generated. This study compares stone ablation threshold, ablation rate, and . Novel thulium laser fiber appears to outperform Holmium:YAG laser. The Fiber Dust features the latest laser technologies from Quanta System. Similar to holmium, the thulium laser can be used for vaporization, resection, or enucleation. Revolix laser is a medical laser used for the treatment of enlarged prostate. Holmium laser operates at 2100 nm in the near infrared spectrum. Its new Xpeeda side-firing fibre releases more energy directly into the tissue because it is able to come into contact with it. Innovative Laser Technology May Reduce Treatment Time and Increase Procedural Efficiency The first major innovation in fiber laser technology in the past 20 years, the Soltive SuperPulsed Laser System for applications in stone lithotripsy and soft tissue can dust stones in half the time it takes other laser systems and offers precise soft tissue cutting with visibly improved hemostasis capability. The thulium fiber laser (TFL) has recently arisen as an alternative to the current gold standard for stone lithotripsy—the holmium (Ho:YAG) laser. Re. Libera 120W, the highest power on the market. The holmium laser (λ=2120 nm) was operated with standard parameters of 600 mJ, 350 μs, 6 Hz, and 270-μm-core optical fiber.The TFL (λ=1908 nm) was operated with 35 mJ, 500 μs, 150 to 500 Hz . Methods: Our study investigated and compared an evaluation model of a solid-state Thulium laser with a Medilas H Solvo 35 Holmium laser device, both by Dornier (Dornier MedTech Laser GmbH, Wessling, Germany). 1555 - 1562 A new tool for kidney stone ablation demonstrates strong potential to dust and fragment stones more quickly and efficiently than devices currently available in the United States. 5 Molina, Wilson. Clinical studies are warranted. 1555 - 1562 , 10.1007/s00345-019-02945-x Conclusion: Both holmium and thulium laser transurethral enucleation of the prostate can alleviate LUTS in BPH patients with similar short-time effectiveness. Temperature Rise during Laser Lithotripsy: Comparison of Super-Pulse Thulium Fiber Laser (SPTF) vs. High-Power 120 W Holmium YAG Laser (Ho:YAG). Both holmium and thulium laser transurethral enucleation of the prostate can alleviate LUTS in BPH patients with similar short-time effectiveness. The high-power holmium laser with Moses technology (Lumenis Moses Pulse 120H) and the super-pulse thulium fiber laser (SPTF) have a similar ablative effect when operated at the same power, but when evaluated at maximal dusting settings, the SPTF laser seems to hold an advantage for greater efficiency, according to research reported at the AUA annual meeting in Chicago. April 13, 2020. January 27, 2020. Purpose To compare the perioperative and functional outcomes of holmium laser enucleation of the prostate (HoLEP) and thulium laser enucleation of the prostate (ThuLEP) for the treatment of large-volume benign prostatic hyperplasia (BPH) (&gt; 80 ml). In our study, these forces were measured in the Thulium laser&#x27;s 0.1 J single pulse energies. HoLEP involves enucleation of the median lobe, followed by the lateral lobes. Thulium laser is continuous wave laser which offers numerous potential benefits compared to alternative lasers and surgical procedures used for BPH. However, recent experimental studies have demonstrated that the Thulium fiber laser is also capable of vaporizing urinary stones. In this study the investigators aim to test TGreenlight (532-nm) laser Photoselective Enucleation of the Prostate (Green LEP) using (XPS) 180W system ) vs Thulium Laser 200 W Enucleation of the Prostate (ThuLEP) in reduction of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) in a randomized controlled trial. Standard Fiber. The RevoLix wavelength is similar to Holmium but the emission mode is continuous wave (cw) instead of pulsed - thus . Listing a study does not mean it has been evaluated by the U.S. Federal Government. Holmium laser and thulium laser may seem to be relatively better in terms of surgical efficacy and safety, so that these two lasers might be preferred in the selection of optimal laser surgery . To assess efficacy and safety of Thulium laser enucleation of prostate (ThuLEP) for benign prostatic hyperplasia. Still, compared to holmium laser transurethral enucleation of the prostate (HoLEP) the number of institutes all over the world using Thulium LASER are limited. Laser technology is widely used in urological surgery, from lithotripsy, prostate surgery to en-bloc resection of tumours. Purpose To compare the operating modes of the Holmium:YAG laser and Thulium fiber laser. Publication types Comparative Study Controlled Clinical Trial English Abstract MeSH terms Photons are emitted at 1940 nm wavelength and directed at the operational field via an outgoing laser fiber. 38 A monopolar . The main difference is that holmium has a pulsed energy, while thulium emits a continuous laser wave.5 The only comparative study in a clinical setting of HoLEP and ThuLEP is that of Zhang and col-leagues6 that reported a monocentric randomiza- Rodríguez Socarrás and others published Thulium:YAG vs Holmium:YAG laser effect on soft tissue: Evidence from an ex vivo experimental study | Find, read and cite all . What is HoLEP. No prostate tissue is available to be removed for evaluation by a pathologist.  Similarly, other lasers can be used to ablate or enucleate prostate tissue, for example, Greenlight laser, ProTouch Laser, Thulium laser, and Evolve laser. A number of tunable thulium and holmium lasers have been demonstrated addressing the wavelength region beyond 2.0 µm. At equivalent settings, thulium fiber laser ablation rates were higher than those for holmium:YAG laser in both dusting mode (threefold for COM stones and 2.5-fold for UA stones) and fragmentation mode (twofold for UA stones). The latter has been released in July 2020 in Europe, and only in-vitro studies have been published. The Ti 3 AlC 2 thin film is sandwiched between two fiber ferrules and integrated into thulium doped fiber laser (TDFL) and thulium-holmium doped fiber laser (THDFL) cavities. Revolix laser can be used to ablate prostate tissue or resect it. The novel, pulsed thulium:yttrium aluminum garnet laser (p-Tm:YAG) evaluation model has only been compared with Ho:YAG in terms of its dusting performance to date. Thulium is superior to holmium laser in hemostasis, but inferior to it in anatomical distinctness. Tissue vaporization efficiency of both lasers was compared (n = 10 canine prostates for each laser group). There have been many advances in holmium laser technology to better accommodate surgeon preferences, but the core elements, holmium ion and 2. µm have remained constant. Methods Antegrade ureteroscopy with LL was performed in ex-vivo porcine kidneys with 3 mm . MasterPULSE 51:522-530, 2019. Objective: To compare the clinical outcomes between thulium laser transurethral enucleation of the prostate (ThuLEP) (70 W) and holmium laser transurethral enucleation of the prostate (HoLEP) (90 W) in a prospective randomized trial with 18 months of follow-up. But more research comparing the two is needed, according to a presentation at the 2019 . In this study the investigators aim to test TGreenlight (532-nm) laser Photoselective Enucleation of the Prostate (Green LEP) using (XPS) 180W system ) vs Thulium Laser 200 W Enucleation of the Prostate (ThuLEP) in reduction of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) in a randomized controlled trial. Endosurgical laser treatments for BPH A separate instrument is then used to cut the prostate tissue into easily removable fragments. Similar to holmium, the thulium laser can be used for vaporization, resection, or enucleation. In our study, these forces were measured in the Thulium laser&#x27;s 0.1 J single pulse energies. Jeni Williams. Mean vaporization efficiency measured 5.30 ± 0.48 kJ/g vs. 4.13 ± 0.46 kJ/g for Thulium fiber and Holmium lasers (P &lt;0.05). Urology Times Journal, Vol 48 No 2, Volume 48, Issue 2. Patients and Methods: A total of 174 patients with solitary ureteral calculi were enrolled in 2016 to 2018. Stones are fragmented irrespective of the chemical composition. Jeni Williams. A review by Barbalat and colleagues 4 showed that thulium laser prostatectomy represents a safe and effective procedure. The Olympus EMPOWER Holmium:YAG laser portfolio offers 35W, 65W and 100W systems with a full-range line of laser fibers to meet the diverse lithotripsy challenges physicians face each day. by combining a pulsed Holmium-YAG laser and a continuous wave Thulium-YAG laser in a single box. AUA 2019. A cladding-pumped thulium fiber laser was demonstrated Although Holmium:Yttrium-Aluminum-garnet (Ho:YAG) laser is the current gold-standard in endoscopic laser lithotripsy, there is a lot of buzz around the new thulium fibre laser (TFL). Regarding their physical properties, both lasers are ideal for endourological applications as they are completely absorbed by water, with a tissue penetration depth of 0.4 mm for holmium and of 0.25 mm for thulium laser. Patients will undergo thulium fiber laser enucleation of the prostate (TFLEP) at the Centre Hospitalier de l&#x27;Université de Montréal (CHUM) as a . In HoLAP &quot;ablation&quot; procedure, the tissue is ablated or evaporated. Lasers Surg. Novel thulium laser fiber appears to outperform Holmium:YAG laser. Holmium laser enucleation of the prostate versus thulium laser enucleation of the prostate for the treatment of large-volume prostates &gt; 80 ml: 18-month follow-up results World J Urol , 38 ( 6 ) ( 2020 ) , pp. The Holmium:YAG laser vaporizes prostate tissue at a higher rate than the Thulium fiber laser, for the same average power delivered to the tissue. Tissue vaporization rates measured 0.57 ± 0.05 g/min vs. 0.73 ± 0.07 g/min (P &lt;0.05). 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: Comparison of dusting and fragmenting using the new Super Pulse Thulium Fiber Laser to a 120W Holmium:YAG laser: Dr. Ben Chew: Accepted: WCE 2019 The lobes are placed into the bladder for removal by morcellation. Also called holmium laser enucleation of the prostate (HoLEP), the procedure uses a laser to remove tissue that is blocking urine flow through the prostate. The RevoLix Thulium laser is the only laser system ever developed specifically for soft tissue surgery. Choose between single-use and reusable options. The Holmium:YAG (Ho:YAG) laser lithotriptor is capable of operating at high pulse energies, but its efficient operation is limited to relatively low pulse rates (~10 Hz) during lithotripsy. © 2019 Wile … Although Holmium:Yttrium-Aluminum-garnet (Ho:YAG) laser is the current gold-standard in endoscopic laser lithotripsy, there is a lot of buzz around the new thulium fibre laser (TFL). Fibers are compatible across Quanta&#x27;s holmium and thulium laser systems. HoLEP is recommended by the AUA for BPH treatment. The laser fiber portfolio of the Olympus EMPOWER system offers a ball-tip fiber that allows the physician to insert the fiber through a deflected scope while maintaining visualization of the stone. Materials and methods Medline, Scopus, Embase, and Web of Science databases were searched for articles relating to the operating modes of Holmium:YAG and Thulium fiber lasers, including systematic review of . Laser Lithotripsy During URS - Holmium vs Thulium The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. We compared the temperature profile of both the 120 W Ho:YAG and the 60 W SPTF systems during ureteral lithotripsy. First used for BPH in 2005 by Xia et al., a Tm:YAG laser was used for a procedure known as thulium laser resection of the prostate (TmLRP-TT) in which thulium laser is used to resect the prostate into small tissue chips [49]. The SP TFL FiberLase U2 and 120H Ho:YAG laser with fibers diameters of 400 and 365 μm, respectively . This innovative laser technology seems particularly advantageous for ureteroscopy and may become an important milestone for kidney stone treatmen … With further development, the thulium fiber laser may represent an alternative to the conventional holmium laser for more efficient laser lithotripsy. Precisely cutting through soft tissue and state-of-the-art prostate enucleation, with equivalent or visibly improved hemostasis3 dependent on fiber size. Stone sizes ranged between 0.6 and 2.4 cm. Thulium fiber laser &gt;&gt; Holmium : YAG laser • 1.5-4 times faster stone ablation rate in favor of the Thulium fiber laser 1, 2 • Damages to the proximal fiber end was not found with Thulium fiber laser, while all proximal fiber ends were damaged with Holmium: YAG lithotripsy 3 • Prevention of stone retropulsion during Thulium fiber laser . Holmium laser enucleation of the prostate versus thulium laser enucleation of the prostate for the treatment of large-volume prostates &gt; 80 ml: 18-month follow-up results Both HoLEP and ThuLEP relieve lower urinary tract symptoms in a comparable way with high efficacy and safety. Holmium laser. Highly flexible laser fibres are most suitable for . This Hands-on Training course is to introduce the trainee into the laser tissue interaction of the Thulium and Holmium 2 micron continuous wave and pulsed laser with the use of different training stations: At the cutting effect workstation, the trainee will try the laser on cadaver tissue submerged in water. First used for BPH in 2005 by Xia et al., a Tm:YAG laser was used for a procedure known as thulium laser resection of the prostate (TmLRP-TT) in which thulium laser is used to resect the prostate into small tissue chips [49]. We decided to evaluate the latest data to help create an objective and evidence-based opinion about this new technology and associated clinical outcomes. Lisette Hilton. This study compares stone ablation threshold, ablation rate, and . used the 70-W (Revolix, Katlenburg, Germany) thulium laser system and the 100-W (VersaPulse, Lumenis, Santa Clara, CA) holmium laser system, and randomized 133 patients to ThuLEP and HoLEP. Singly-doped holmium fiber lasers present the most power-scalable method for operation at 2.1 μm with &gt;400 W demonstrated from a monolithic all-fiber system [7]. Revolix laser prostatectomy is an alternative to, and equivalent to TURP, Greenlight laser and Holmium laser (HoLEP/HoLAP). There is a large body of literature comparing the capabilities of Ho:YAG and thulium fiber lasers (TFLs). Recent advances in both Holmium and TFL technology allow operation at similar laser parameters for direct comparison. These differences seemed to be clinically negligible and were within the range of published series of transurethral enucleating techniques. These differences may be attributed to the measuring device. Multiple diode lasers are pumping energy through the fiber and excite the thulium ions. The laser settings were matched in terms of pulse energy, pulse repetition rate, and average power. Urology Times Journal, Vol 48 No 2, Volume 48, Issue 2. Background: Holmium:yttrium aluminum garnet laser (Ho:YAG) is still considered the gold standard in laser lithotripsy. Purpose: To evaluate the efficacy of new super pulse thulium fiber laser (SP TFL) and compare it with holmium laser for ureterolithotripsy. Thulium fiber laser (TFL) is a novel laser technology that delivers a pulsed laser at a more optimal wavelength and a shallower depth of tissue penetration leading to better hemostatic properties. Especially holmium and thulium lasers offer advanced performance with a lower intraoperative bleeding risk and shorter hospital stays and catheterization of patients,making endoscopic procedures safer and less invasive than traditional surgical techniques and open surgery. The use of the thulium:YAG laser with its physical properties might be the reason for the short learning curve: contrary to the pulsed holmium:YAG laser, the energy of the thulium:YAG laser is delivered in a continuous wave mode and offers a high ablation capacity combined with an excellent hemostasis and coagulation, to perform a smooth . RevoLix 200 Laser The RevoLix 200 is the newest Thulium laser development of LISA Laser Products and the only laser which is offering 200 watt at the wavelength of 2 micron for Incision, Vaporisation and Excision of soft tissue. 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