What is it about?

This study sought to identify the optimal laser settings and treatment strategies for Thulium Fiber Laser (TFL) lithotripsy, a cutting-edge method for breaking down kidney stones. Using an in vitro kidney model, researchers discovered that high pulse energy (Ep) and low frequency (F) settings, like 0.8 J/12 Hz, were most effective. These settings not only doubled treatment efficiency and reduced procedure time by 36% but also minimized the risk of thermal injury to surrounding tissues compared to conventional low Ep/high F settings, a significant improvement that could benefit both patients and healthcare providers by reducing the duration of the procedure and associated costs. This balance between "efficient stone dusting" and "low thermal injury risk" makes the high Ep/low F combination at low power settings an ideal option for safe and effective kidney stone treatment. Further research is needed to test these settings on various stone types and anatomical variations.

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Why is it important?

This research is crucial as it identifies the optimal settings for Thulium Fiber Laser (TFL) lithotripsy, enhancing treatment efficiency, reducing procedure time, and minimizing thermal injury. Optimizing these settings can lead to shorter procedures, reducing overall healthcare costs, fewer follow-ups, and improved patient safety. With the rising prevalence of kidney stones and the ongoing advancements in laser technology, this research is both timely and crucial. It addresses a pressing need for more efficient and safer treatment options, potentially transforming the standard of care in urology.

Perspectives

I'm thrilled about this publication because it represents a significant advancement in the application of laser technology for medical treatments. The research on optimizing Thulium Fiber Laser (TFL) settings for kidney stone treatment is a game-changer, promising faster procedures, fewer complications, and better patient outcomes. What excites me is the direct benefit to patient care—by refining these settings, we’re not just enhancing a technique, but setting a new standard for safer, more efficient treatment. This work highlights the power of interdisciplinary innovation, and I’m proud to be part of a team driving such transformative advances.

Arpit Mishra
Duke University

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This page is a summary of: Exploring optimal settings for safe and effective thulium fibre laser lithotripsy in a kidney model, BJU International, November 2023, Wiley,
DOI: 10.1111/bju.16218.
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