{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:19:31Z","timestamp":1791487171820,"version":"4.3.4"},"reference-count":46,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Laser lithotripsy carries an inevitable risk of collateral tissue injury. This study compared the safety profiles of pulsed Holmium:YAG and Thulium:YAG lasers by examining their effects on soft tissue under laser settings relevant to lithotripsy, using ex vivo porcine kidney models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Direct laser impacts were applied to porcine renal parenchyma and pelvis at constant fiber movements and clinical laser settings (0.2\u20133.5\u2009J, 10\u201340\u2009Hz, 2\u201340\u2009W), with high\u2010power extensions for the Thulium:YAG laser up to 80\u2009W\/200\u2009Hz. From 560 histological sections, coagulation and cutting depths were measured and clustered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At equivalent power, the Thulium:YAG laser operated with longer pulses than Holmium:YAG, reducing pulse energy per time (pulse power\u2009\u2264\u20093362 vs. \u2264\u20097777\u2009W). Holmium:YAG laser produced deeper lacerations up to 9.3\u2009mm in renal parenchyma, compared to 5.0\u2009mm with the Thulium:YAG laser. In renal pelvis, maximal cut depth was 3.6\u2009mm with Holmium:YAG\u2014twice as that observed with the Thulium:YAG. While pulse power was a primary determinant for soft tissue damage, high frequencies (100\u2013200\u2009Hz) did not elevate it. Cluster analysis identified laser\u2010specific damage profiles: Thulium:YAG favored coagulative damage at limited depths, whereas Holmium:YAG induced deep lacerations with limited coagulation and tissue detachment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Soft tissue safety and complication risk depend on laser parameters and choice of technology. Reduced pulse powers maximize safety, instead pulse frequency seems safe to elevate for improved efficiency. At power levels beyond 20\u2009W, Thulium:YAG benefited from longer pulses showing safer profiles, with shallower penetration and more reliable coagulation compared to Holmium:YAG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lsm.70173","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:22:24Z","timestamp":1784114544000},"page":"811-820","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Soft Tissue Safety Assessment of Pulsed Solid\u2010State Thulium:YAG Versus Holmium:YAG Lasers: A Quantitative Porcine Model Simulation"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0561-9980","authenticated-orcid":false,"given":"Dennis","family":"Buente","sequence":"first","affiliation":[{"name":"Department of Urology Faculty of Medicine, University of Freiburg \u2010 Medical Centre Freiburg Baden\u2010W\u00fcrttemberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5725-8780","authenticated-orcid":false,"given":"Rodrigo","family":"Suarez\u2010Ibarrola","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Medicine, University of Freiburg \u2010 Medical Centre Freiburg Baden\u2010W\u00fcrttemberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4287-7380","authenticated-orcid":false,"given":"Shane","family":"O'Sullivan","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Medicine, University of Freiburg \u2010 Medical Centre Freiburg Baden\u2010W\u00fcrttemberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5894-9647","authenticated-orcid":false,"given":"Arkadiusz","family":"Miernik","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Medicine, University of Freiburg \u2010 Medical Centre Freiburg Baden\u2010W\u00fcrttemberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8033-8858","authenticated-orcid":false,"given":"Ralf","family":"Petzold","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Medicine, University of Freiburg \u2010 Medical Centre Freiburg Baden\u2010W\u00fcrttemberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.22348"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2022.03.018"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.5173\/ceju.2023.24"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v9.i16.3914"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00414-021-02540-z"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000502159"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-022-01168-4"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-963545"},{"key":"e_1_2_9_10_1","unstructured":"Jena Surgical MultiPulse Holmium 150W Laser with Morcellator for sale from Innologic \u2010 MedicalSearch Australia MedicalSearch accessed September 26 2024 https:\/\/www.medicalsearch.com.au\/multipulse-holmium-150w-laser-with-morcellator\/p\/224594."},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41585-018-0035-8"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2020.0090"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2017.0050"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.20196"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1117\/1.3564884"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.23057"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.4111\/icu.20200467"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-014-1429-8"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-022-04242-6"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2021.0742"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2020.0525"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-022-01402-6"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-007-0184-5"},{"key":"e_1_2_9_24_1","first-page":"1","volume-title":"Conference Proceedings","author":"Fried N.","year":"2019"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-019-02654-5"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-018-2589-8"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2018.0572"},{"key":"e_1_2_9_28_1","first-page":"99","article-title":"Mechanisms of Laser\u2010Tissue Interaction: II. Tissue Thermal Properties","volume":"4","author":"Ansari M. A.","year":"2013","journal-title":"Journal of Lasers in Medical Sciences"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2020.0222"},{"key":"e_1_2_9_30_1","unstructured":"Thulio Technical Insights\u00ae. Dornier MedTech accessed September 26 2024 https:\/\/www.dornier.com\/thulio-technical-insights\/."},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15079"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2021.01.012"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2020.0526"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-022-01117-6"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1117\/1.JBO.17.6.068005"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.4274\/jus.galenos.2025.2024-12-1"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-025-05713-2"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2024.0349"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-021-03825-z"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euros.2024.07.114"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40064-016-1750-3"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2020.0803"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-11917-1"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1177\/08927790251377787"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2024.0424"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-021-01282-2"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-023-04652-0"}],"container-title":["Lasers in Surgery and Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lsm.70173","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lsm.70173","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lsm.70173","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:35:34Z","timestamp":1791484534000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lsm.70173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,15]]},"references-count":46,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1002\/lsm.70173"],"URL":"https:\/\/doi.org\/10.1002\/lsm.70173","archive":["Portico"],"relation":{},"ISSN":["0196-8092","1096-9101"],"issn-type":[{"value":"0196-8092","type":"print"},{"value":"1096-9101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,15]]},"assertion":[{"value":"2026-01-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}