{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:51:57Z","timestamp":1791870717462,"version":"4.3.4"},"reference-count":27,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T00:00:00Z","timestamp":1671840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Objective: To support the efficacy and safety of a range of thulium fiber laser (TFL) pre-set parameters for laser lithotripsy: the efficiency is compared against the Holmium:YAG (Ho:YAG) laser in the hands of juniors and experienced urologists using an in vitro ureteral model; the ureteral damage of both lasers is evaluated in an in vivo porcine model. (2) Materials and Methods: Ho:YAG laser technology and TFL technology, with a 200 \u00b5m core-diameter laser fibers in an in vitro saline ureteral model were used. Each participant performed 12 laser sessions. Each session included a 3-min lasering of stone phantoms (Begostone) with each laser technology in six different pre-settings retained from the Coloplast TFL Drive user interface pre-settings, for stone dusting: 0.5 J\/10 Hz, 0.5 J\/20 Hz, 0.7 J\/10 Hz, 0.7 J\/20 Hz, 1 J\/12 Hz and 1 J\/20 Hz. Both lasers were also used in three in vivo porcine models, lasering up to 20 W and 12 W in the renal pelvis and the ureter, respectively. Temperature was continuously recorded. After 3 weeks, a second look was done to verify the integrity of the ureters and kidney and an anatomopathological analysis was performed. (3) Results: Regarding laser lithotripsy efficiency, after 3 min of continuous lasering, the overall ablation rate (AR) percentage was 27% greater with the TFL technology (p &lt; 0.0001). The energy per ablated mass [J\/mg] was 24% lower when using the TFL (p &lt; 0.0001). While junior urologists performed worse than seniors in all tests, they performed better when using the TFL than Ho:YAG technology (36% more AR and 36% fewer J\/mg). In the in vivo porcine model, no urothelial damage was observed for both laser technologies, neither endoscopically during lasering, three weeks later, nor in the pathological test. (4) Conclusions: By using Coloplast TFL Drive GUI pre-set, TFL lithotripsy efficiency is higher than Ho:YAG laser, even in unexperienced hands. Concerning urothelial damage, both laser technologies with low power present no lesions.<\/jats:p>","DOI":"10.3390\/jcm12010149","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T02:53:11Z","timestamp":1672109591000},"page":"149","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Laser Efficiency and Laser Safety: Holmium YAG vs. Thulium Fiber Laser"],"prefix":"10.3390","volume":"12","author":[{"given":"Alba","family":"Sierra","sequence":"first","affiliation":[{"name":"Urology Department, Hospital Cl\u00ednic de Barcelona, Villarroel 170, 08036 Barcelona, Spain"},{"name":"GRC Urolithiasis No. 20, Tenon Hospital, Sorbonne University, F-75020 Paris, France"},{"name":"Department of Urology AP-HP, Tenon Hospital, Sorbonne University, F-75020 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1461-8464","authenticated-orcid":false,"given":"Mariela","family":"Corrales","sequence":"additional","affiliation":[{"name":"GRC Urolithiasis No. 20, Tenon Hospital, Sorbonne University, F-75020 Paris, France"},{"name":"Department of Urology AP-HP, Tenon Hospital, Sorbonne University, F-75020 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6248-6478","authenticated-orcid":false,"given":"Bhaskar","family":"Somani","sequence":"additional","affiliation":[{"name":"Urology Department, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Traxer","sequence":"additional","affiliation":[{"name":"GRC Urolithiasis No. 20, Tenon Hospital, Sorbonne University, F-75020 Paris, France"},{"name":"Department of Urology AP-HP, Tenon Hospital, Sorbonne University, F-75020 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Geraghty, R.M., Davis, N.F., Tzelves, L., Lombardo, R., Yuan, C., Thomas, K., Petrik, A., Neisius, A., T\u00fcrk, C., and Gambaro, G. 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Endourol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/149\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:50:27Z","timestamp":1760147427000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,24]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["jcm12010149"],"URL":"https:\/\/doi.org\/10.3390\/jcm12010149","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,24]]}}}