Abstract
Minimally invasive surgery (MIS) has seen large uptake in recent decades, with increasing numbers of such procedures being performed. Laser technology is widely used in the management of urological diseases, including urolithiasis, benign prostatic enlargement (BPE), and urinary tract malignancies.(1,2) Laser lithotripsy was first adopted by urologists in the 1980s, with Holmium:Yttrium- Aluminium-Garnet (Ho:YAG) becoming the laser of choice in the mid 1990s( 3,4) Compared to other lithotripsy techniques, the Holmium:YAG laser presents several important advantages: (1) suitability for fragmentation of all known urinary stone types into small stone particles (3,4); (2) ability to operate with thin and flexible delivery fibers with limited energy losses and with core diameters as small as 200 μm (5,6); (3) favorable safety profile with minimal tissue penetration depth and low risk of undesirable tissue damage due to the relatively high absorption coefficient of the Holmium:YAG laser wavelength in water(7) In recent years, there has been a surge of interest in Thulium Fiber Laser (TFL) which has a 4x higher absorption coefficient in water-containing tissue, smaller operating fibers (50–150 μm core diameter), lower energy pulses (0.025 J), and higher pulse rate capability (up to 2 KHz).(2) One advantage of TFL is its higher water-absorption coefficient compared with Ho:YAG, which means that water absorbs TFL energy around four times higher than it does with Ho:YAG laser energy. Using water absorption as a model for cell absorption, the implication of this is that more energy from TFL is absorbed by cells and therefore they are better ablated (8,9)
Recommended Citation
Al-Kawaz, Ula
(2020)
"Thulium Fiber Laser in Urology,"
Iraqi Postgraduate Medical Journal: Vol. 20:
Iss.
4, Article 1.
DOI: 10.52573/ipmj.2020.170473
Available at:
https://www.ipmj.org/journal/vol20/iss4/1
DOI
10.52573/ipmj.2020.170473