Mp78-03 Superpulsed Thulium Fiber™ Versus High-Power Holmium:yag Laser in Mini-Endoscopic Combined Intrarenal Surgery for Treatment of Kidney Stones: A Practical Comparison

You have accessJournal of UrologyStone Disease: Surgical Therapy (Including ESWL) V (MP78)1 May 2024MP78-03 SUPERPULSED THULIUM FIBER™ VERSUS HIGH-POWER HOLMIUM:YAG LASER IN MINI-ENDOSCOPIC COMBINED INTRARENAL SURGERY FOR TREATMENT OF KIDNEY STONES: A PRACTICAL COMPARISON Lucas B. Vergamini, Willian Ito, Nicholas Choi, Crystal Valadon, Mihaela E. Sardiu, Holly E. Du, Bristol Whiles, Donald Neff, David Duchene, and Wilson R. Molina Lucas B. VergaminiLucas B. Vergamini , Willian ItoWillian Ito , Nicholas ChoiNicholas Choi , Crystal ValadonCrystal Valadon , Mihaela E. SardiuMihaela E. Sardiu , Holly E. DuHolly E. Du , Bristol WhilesBristol Whiles , Donald NeffDonald Neff , David DucheneDavid Duchene , and Wilson R. MolinaWilson R. Molina View All Author Informationhttps://doi.org/10.1097/01.JU.0001008856.05210.73.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Miniaturized endoscopic combined intrarenal surgery (mini-ECIRS) comprises the simultaneous use of two different but complementary surgical techniques to treat kidney stones: miniaturized percutaneous nephrolithotomy and retrograde intrarenal surgery. This study aims to address the literature paucity regarding the outcomes of the utilization of the high-power Holmium:YAG (HoYAG) vs. thulium fiber laser (TFL) in mini-ECIRS. METHODS: Retrospective cohort data on patients undergoing supine mini-ECIRS were collected from 08/2021-05/2023, regardless of stone size or complexity. Exclusion criteria included patients with urinary diversion (i.e., ileal conduit), simultaneous utilization of>1 laser platform, cases using any other form of fragmentation, and patients with ureteral stones. The HoYAG platform (Lumenis Pulse P120H™, 120 W, Boston Scientific®) and the TFL (Soltive SuperPulsed Thulium Fiber (SPTF), 60W, Olympus®) were compared. Perioperative antibiotics were managed per EDGE consortium criteria. Data on Stone-free rate (SFR) determined by assessing a CT scan performed on the first postoperative day was presented as: absence of stone fragments, no fragments larger than 2 mm or 4 mm. RESULTS: A total of 100 patients met the study criteria, including 51 ECIRS patients with HoYAG and 49 with SPTF. Table 1 exhibits patients' demographics and stone characteristics, with no significant differences between groups. HoYAG utilized less energy and time, resulting in higher ablation efficiency (p<0.05) and less total operative time (p<0.05). Overall, there was no difference in SFR in any category between HoYAG and SPTF (no fragments: RR 0.81, CI 95% 0.59–1.12, p=0.21; fragments <2 mm: RR 0.86, CI 95% 0.67–1.10, p=0.23; fragments <4 mm: RR 0.96, CI 95% 0.80–1.15, p=0.67) (Table 2). CONCLUSIONS: Although we observed an equivalent postoperative SFR, this study depicts a faster operative time and higher intraoperative laser efficiency with the HoYAG over the SPTF in mini-ECIRS. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1263 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Lucas B. Vergamini More articles by this author Willian Ito More articles by this author Nicholas Choi More articles by this author Crystal Valadon More articles by this author Mihaela E. Sardiu More articles by this author Holly E. Du More articles by this author Bristol Whiles More articles by this author Donald Neff More articles by this author David Duchene More articles by this author Wilson R. Molina More articles by this author Expand All Advertisement PDF downloadLoading ...