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A motorized arm applied the laser at a constant speed (0.7\u00a0mm\/s). Laser settings included 1.5\u00a0J \u00d7 5\u00a0Hz, 1\u00a0J \u00d7 20\u00a0Hz, and 0.3\u00a0J \u00d7 50\u00a0Hz, with five 21-mm cuts per setting. AV was calculated from width and depth measurements using an optical microscope. ANOVA was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 750 measurements, TFL-200\u00a0\u03bcm achieved the highest AV in most settings. At 1.5\u00a0J x 5\u00a0Hz, TFL-200\u00a0\u03bcm (15.9\u00a0mm\u00b3) significantly outperformed MOSES\u2122 (LP: 11\u00a0mm\u00b3, SP: 10.4\u00a0mm\u00b3, MD: 9.7\u00a0mm\u00b3) and Magneto (9.1\u00a0mm\u00b3) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). At 1\u00a0J \u00d7 20\u00a0Hz, TFL-200\u00a0\u03bcm (21.2\u00a0mm\u00b3) exceeded all technologies (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). At 0.3\u00a0J x 50\u00a0Hz, TFL-200\u00a0\u03bcm (8.9\u00a0mm\u00b3) outperformed MOSES\u2122 MD (3.8\u00a0mm\u00b3) and Magneto (4.9\u00a0mm\u00b3),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05. TFL-150\u00a0\u03bcm showed comparable AV to Ho: YAG lasers across settings, except at 1\u00a0J x 20\u00a0Hz, where it was lower than TFL-200\u00a0\u03bcm and CyberHo150 SP and VT\u2122 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), primarily due to lower depth of fissure (DOF) while width of fissure (WOF) remained comparable. At 0.3\u00a0J \u00d7 50\u00a0Hz, TFL-150\u00a0\u03bcm (6.7\u00a0mm\u00b3) demonstrated lower AV than CyberHo150 SP (10.9\u00a0mm\u00b3;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), but higher AV than MOSES\u2122 MD (3.8\u00a0mm\u00b3;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TFL-200\u00a0\u03bcm achieved higher AV than Ho: YAG in most settings, but statistical significance was observed in one-third of comparisons. TFL-150\u00a0\u03bcm demonstrated similar AV to Ho: YAG, except in cases where Ho: YAG had higher DOF. TFL-150\u00a0\u03bcm has known advantages in terms of irrigation, visibility, ureteroscope tip deflection, and potential for miniaturization of flexible ureteroscopy devices and aspiration methods, supporting its potential applicability for dusting strategies while maintaining comparable AV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-026-06514-x","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T18:05:11Z","timestamp":1781805911000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of TFL and high-power Ho: YAG lasers with multiple pulse modulations: an in vitro study"],"prefix":"10.1007","volume":"44","author":[{"given":"Alejandra","family":"Bravo-Balado","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"S\u00e1nchez-Puy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Izquierdo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Diana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Piana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damiano","family":"Stracci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Arena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00edlvia","family":"Gr\u00e0cia Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s Koey","family":"Kanashiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e9lix","family":"Mill\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"S\u00e1nchez-Mart\u00edn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Esquinas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oriol","family":"Angerri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Traxer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Palou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban","family":"Emiliani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"6514_CR1","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1159\/000448692","volume":"98","author":"S Chen","year":"2017","unstructured":"Chen S, Zhou L, Wei T et al (2017) Comparison of Holmium: YAG laser and pneumatic lithotripsy in the treatment of ureteral stones: an update meta-analysis. 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Oriol Angerri is a consultant and speaker for Boston Scientific and Cook Medical, consultant for Ambu and Karl Storz and speaker for Derivare. Olivier Traxer is a consultant for Karl Storz, Coloplast, IPG photonics, Ambu, Quanta System and Rocamed.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"It was waived by the local Ethics Committee of our institution because no patient\u2019s data were involved.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"438"}}