holmium vs thulium laser

By using the hybrid gas phase-solution doping process in conjunction with the MCVD preform fabrication technique, the doping concentration and the Tm:Ho ratio were varied to study the energy transfer efficiency from Tm3+ to Ho3+. These features of the holmium laser could be the cause of increased stress, inflammation and edema in proximity of the external urinary sfincter, explaining the higher rate of AUR and stress incontinence. The experimental Thulium fiber laser (TFL) is currently being studied as a potential alternative to the gold standard Holmium:YAG laser for lithotripsy. th World . Holmium Versus Thulium Laser Enucleation of the Prostate ... 143 articles matched initial search. Holmium lasers are intended solely for use by physicians trained in the use of the Ho:YAG (2.1 μm) wavelength. This study compares stone ablation threshold, ablation rate, and . Thulium fiber laser lithotripsy in an in vitro ureter model 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. 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) (> 80 ml). There is a large body of literature comparing the capabilities of Ho:YAG and thulium fiber lasers (TFLs). This study compares stone ablation threshold, ablation rate, and . Study on the dopant concentration ratio in thulium-holmium ... Holmium laser enucleation of the prostate versus thulium laser enucleation of the prostate for the treatment of large-volume prostates > 80 ml: 18-month follow-up results World J Urol , 38 ( 2020 ) , pp. Holmium laser is used for both procedures. Highly flexible laser fibres are most suitable for . Urology Surgery » Advanced Energy Technologies by OmniGuide Thulum laser has a wavelength of 2 um, which is nearing the absorption peak of water, therefore it has the most efficient vaporization . Endosurgical laser treatments for BPH 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. Lithotripsy in the lower, medial and upper tract with rigid and flexible instruments is accomplished by the integrated Holmium laser. The SOLTIVE Laser system is a compact system which is significantly smaller than Holmium laser systems. Holmium metal is very soft and malleable. Thulium fiber laser technology explained. Temperature Rise during Laser Lithotripsy: Comparison of Super Pulse Thulium Fiber LASER (SPTF) vs High Power 120W Holmium-YAG LASER (Ho:YAG) Molina, W., et al. They found that the total time of fragmenting was much faster while using the Thulium fiber laser at its ideal laser setting. Holmium laser enucleation of the prostate versus thulium laser enucleation of the prostate for the treatment of large-volume prostates > 80 ml: 18-month follow-up results World J Urol. Photons are emitted at 1940 nm wavelength and directed at the operational field via an outgoing laser fiber. 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. 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). 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). Similarly, other lasers can be used to ablate or enucleate prostate tissue, for example, Greenlight laser, ProTouch Laser, Thulium laser, and Evolve laser. PDF | On Jan 1, 2020, M.E. Similar to other rare-earth ions, trivalent Holmium and Thulium ions have a unique set of emission wavelengths, particularly in the near-infrared range. 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- Recovery after laser enucleation of the prostate is typically relatively uneventful for most patients. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Incorrect treatment settings can cause serious tissue damage. 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. Both Holmium and Thulium are predominantly found as trivalent ions in nature and in industrial applications such as lasers. Holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripsy originated in the early 1990s 1 and has evolved to become the gold standard in endoscopic stone treatment. It is important to understand that while laser enucleation of the prostate can be done with various lasers, the recovery process is the same, whether the procedure is done with Holmium laser (HoLEP), Greenlight laser (GreenLEP), Thulium laser (ThuLEP), ProTouch laser, or Evolve laser. Multiple diode lasers are pumping energy through the fiber and excite the thulium ions. Objective. In direct comparisons at 1.0 J/5 Hz, Holmium and Thulium produced comparable values of 8.1 N and 7.5 N, respectively, with a slight but signicant advantage for Thu-lium (p <0.05). 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. However, recent reports about a new prototype thulium fiber laser (TFL) lithotripter have revealed impressive levels of performance. Properties of Thulium Laser. By adjusting the mirror reflectivity, the ability to control the laser's wavelength is demonstrated. This innovative laser technology seems particularly advantageous for ureteroscopy and may become an important milestone for kidney stone treatmen … Both the Thulium fiber laser and Holmium:YAG lasers are capable of vaporizing prostate tissue at a rate > 1 g/min if operated at the high powers (100-W) typically used in the clinic. 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. At 2.0 J/5 Hz and 3.0 J/10 Hz, the Hol-mium laser delivered significantly greater retropulsion forces (+74.6%) than the Thulium device: 11.6 N vs 7.70 N and Laser Lithotripsy During URS - Holmium vs Thulium The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. However, recent experimental studies have demonstrated that the Thulium fiber laser is also capable of vaporizing urinary stones. The high‐temperature water absorption coefficient for the thulium wavelength (µa = 160 cm−1 at λ = 1,908 nm) is significantly higher than for the holmium wavelength (µa = 28 . Holmium laser prostate surgery is a minimally invasive treatment for an enlarged prostate. Urology Times Journal, Vol 48 No 2, Volume 48, Issue 2. 4 In the shadow of Ho:YAG laser lithotripsy, thulium fiber . 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. This study compares stone ablation threshold, ablation rate, and . 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). Recovery after laser enucleation of the prostate is typically relatively uneventful for most patients. Listing a study does not mean it has been evaluated by the U.S. Federal Government. This laser operated with 11 mW of optical power, a 57-percent slope efficiency, and 120-mW threshold vs absorbed diode power laser for the 60-micron beam radius. However, recent experimental studies have demonstrated that the thulium fiber laser is also capable of vaporizing urinary stones. 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). Patients will undergo thulium fiber laser enucleation of the prostate (TFLEP) at the Centre Hospitalier de l'Université de Montréal (CHUM) as a . 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. 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. Background: Holmium:yttrium aluminum garnet laser (Ho:YAG) is still considered the gold standard in laser lithotripsy. It is important to understand that while laser enucleation of the prostate can be done with various lasers, the recovery process is the same, whether the procedure is done with Holmium laser (HoLEP), Greenlight laser (GreenLEP), Thulium laser (ThuLEP), ProTouch laser, or Evolve laser. The thulium:YAG laser resulted in lower blood loss statistically compared with the holmium:YAG laser (130.1 vs 166.6 mL, respectively). Fragmenting was performed using 120W Holmium:YAG laser, while dusting was performed using a Thulium laser fiber. The TFL employs a diode source rather than a flash lamp system. 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. This versatility is achieved by combining a pulsed Holmium laser with a continuous wave Thulium laser in a single laser unit. Jeni Williams. 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. 1) [8, 21, 22]. Molina WR, Carrera RV, Chew BH, Knudsen BE (2021) Temperature rise during ureteral laser lithotripsy: comparison of super pulse thulium fiber laser (SPTF) vs high power 120 W holmium-YAG laser (Ho:YAG). ThuLEP may have several advantages over the holmium laser, including improved spatial beam quality and more precise tissue incision [ 10 ]. Similar to holmium, the thulium laser can be used for vaporization, resection, or enucleation. A separate instrument is then used to cut the prostate tissue into easily removable fragments. We present the fabrication and laser performance of thulium-holmium co-doped silica fibers when cladding pumped at ∼790 nm. 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. 12 , 17 Results 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 . 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. 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. January 27, 2020. Holmium is a chemical element having the atomic number 67 and chemical symbol Ho while thulium is a chemical element having the atomic number 69 and chemical symbol Tm. 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. 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 key difference between holmium and thulium is that holmium is relatively soft, whereas thulium is very soft that we can cut the metal with a knife. Recent advances in both Holmium and TFL technology allow operation at similar laser parameters for direct comparison. 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. 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). The laser should be used only on tissues that are fully observable. Thulum laser has a wavelength of 2 um, which is nearing the absorption peak of water, therefore it has the most efficient vaporization . Thulium Laser Compared to Holmium Laser Lithotripsy Ralf Petzold, MD, MSc, Arkadiusz Miernik, MD, and Rodrigo Suarez-Ibarrola, MD, BSc Abstract Purpose: To examine the dusting performance of a novel solid state Thulium laser device compared to a standard holmium:yttrium-aluminum-garnet (Ho:YAG) device. Introduction The holmium:YAG laser is currently the most common laser lithotripter. Background: Holmium:yttrium aluminum garnet laser (Ho:YAG) is still considered the gold standard in laser lithotripsy. 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. 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. A separate instrument is then used to cut the prostate tissue into easily removable fragments. Eur Urol Suppl. Stable Q-switched . In open prostatectomy, the surgeon performs digital enucleation of the prostate mainly via incised bladder wall or prostatic capsule. The experimental Thulium fiber laser (TFL) is currently being studied as a potential alternative to the gold standard Holmium:YAG laser for lithotripsy. These procedures were performed until the particles were reduced to less than 1 mm. The aim of this work was to compare the fragmentation efficiency of a novel, pulsed Thulium solid-state laser (p-Tm:YAG) to that of a chopped Thulium fibre laser (TFL) and a pulsed Holmium solid . See the system user manual for a complete list of contraindications and risks. Novel thulium laser fiber appears to outperform Holmium:YAG laser. Methods A total of 116 consecutive patients with BPH were randomized to be treated surgically with either HoLEP (n = 58) or ThuLEP (n = 58 . It was . Introduction. 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. Holmium and TFL were compared for dusting using three groups, G1: 0.2 J/50 Hz . 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. 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. Journal of Endourology, 2019 7. These differences seemed to be clinically negligible and were within the range of published series of transurethral enucleating techniques. RIRS Vs MINIPERC 2019 HyderabadOrganised by :PREETI UROLOGY AND KIDNEY HOSPITALKukatpally -- Lingampally 2 Laser power settings have increased as much as 140 W, 3 which have also improved efficiency with even more sophisticated pulse modulation technologies. Recent advances in both Holmium and TFL technology allow operation at similar laser parameters for direct comparison. There is a large body of literature comparing the capabilities of Ho:YAG and thulium fiber lasers (TFLs). The single-frequency lasing spectrum of the holmium laser is shown. The high-temperature water absorption coefficient for the Thulium wavelength (μ_a = 160 cm^-1 at λ = 1908 nm) is significantly greater than for the Holmium . 2017; 16 (3):e391-e392. Holmium metal is well known for its corrosion resistivity. Thulium fiber laser (TFL) uses long, thin and thulium-doped silica fiber as the active laser medium. Tissue vaporization rates measured 0.57 ± 0.05 g/min vs. 0.73 ± 0.07 g/min (P <0.05). Only Tm-169 isotope of Thulium metal occur naturally. Thulium metal can resist corrosion due to dry air . Thulium laser is a faster cutting laser while diode laser is a portable laser device. Recent advances in Holmium and Thulium fiber lasers (TFL) enable operation at similar parameters for comparison. [2] But recently its position begins to be challenged and the transurethral holmium laser enucleation of the prostate (HoLEP) is a potential one of many outstanding challenges. We therefore decided to systematically review the reality and expectations for this new TFL technology. Holmium laser prostate surgery is a minimally invasive treatment for an enlarged prostate. 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. 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. The main difference between the two lasers is that holmium has a pulsed energy, while thulium emits a continuous laser wave [ 9 ]. Unique Combined Thulium/ Holmium Laser - for BPH and Stones RevoLix DUO is the first and only universal laser in urology for lithotripsy, BPH, endoscopic, laparoscopic and open surgery. 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. This study compares stone ablation threshold, ablation rate, and . 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. 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 . Stones are fragmented irrespective of the chemical composition. Glybochko P, Altshuler G, Vinarov A, Rapoport L, Enikeev M, Grigoriev N, et al. Transurethral resection of the prostate (TURP) has historically been the standard surgical treatment for patients with benign prostatic hyperplasia (BPH). 2.2 Sources Found in Minerals, Mining, Ores of Minerals Found in Minerals, Mining, Ores of Minerals 2.3 History 2.3.1 Who Discovered ThuLEP was statistically superior to HoLEP in operation time and enucleation time, although the differences were clinically negligible. 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. 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. Thulium laser is continuous wave laser which offers numerous potential benefits compared to alternative lasers and surgical procedures used for BPH. After removing duplicates, 28 were excluded (language other than English, abstract-only studies) while 53 were screened. Mean vaporization efficiency measured 5.30 ± 0.48 kJ/g vs. 4.13 ± 0.46 kJ/g for Thulium fiber and Holmium lasers (P <0.05). 226 Comparison between the possibilities of holmium and thulium laser in lithotripsy in vitro. The higher water absorption coefficient (WAC) and shorter aqueous optical penetration depth result in a lower ablation threshold (up to four-times) compared to the holmium laser (Fig. 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). Tissue vaporization efficiency of both lasers was compared (n = 10 canine prostates for each laser group). 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 . The main difference is that holmium has a pulsed energy, while thulium emits a continuous laser wave.5 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). penetration depth of 0.4 mm for holmium and of 0.25 mm for thulium laser. Moreover, the holmium laser penetrates deeper into the prostatic tissue compared to the thulium laser (0.4 vs 0.25 nm). Thulium fiber laser >> Holmium : YAG laser • Thulium fiber laser requires less heat dissipation and can potentially operate at high-power ranges (>50 W) and high-frequency ranges (up to 2000 Hz) with forced air, compared to water-cooled Holmium : YAG lasers; 1 , 2 • Architecture of fiber lasers is insensitive to shock-related damages .

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