You have accessJournal of UrologyStone Disease: Surgical Therapy V (PD34)1 Apr 2020PD34-04 URETEROSCOPIC PERFORMANCE OF THULIUM FIBER LASER (SOLTIVE PREMIUM SUPER PULSED LASERTM) FOR THE TREATMENT OF UROLITHIASIS: RESULTS OF THE FIRST CASE SERIES IN THE UNITED STATES Raphael Carrera*, Joseph Randall, Maurilio Garcia-Gil, Bodo Knudsen, Ben Chew, Jeffrey Thompson, Mitchell Humphreys, and Wilson Molina Raphael Carrera*Raphael Carrera* More articles by this author , Joseph RandallJoseph Randall More articles by this author , Maurilio Garcia-GilMaurilio Garcia-Gil More articles by this author , Bodo KnudsenBodo Knudsen More articles by this author , Ben ChewBen Chew More articles by this author , Jeffrey ThompsonJeffrey Thompson More articles by this author , Mitchell HumphreysMitchell Humphreys More articles by this author , and Wilson MolinaWilson Molina More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000905.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteroscopy with laser lithotripsy is commonly used in the treatment of urolithiasis. Recent in vitro studies demonstrate efficacy of the Thulium Fiber Laser (SOLTIVE Premium Super Pulsed LaserTM) during lithotripsy and a safety profile comparable to Ho:YAG systems. SOLTIVE has the advantages of smaller fiber compatibility and higher frequency dusting settings. In this study we report the first case series of ureterorenoscopy in the United States using the Thulium Fiber Laser for the treatment of upper urinary tract stones. METHODS: After Institutional Review Board approval, a multicentric retrospective chart review of patients treated with the Thulium Fiber Laser from 10/8/19 to 10/24/19 was conducted. Basic demographic information, pre-operative, and peri-operative data were recorded. RESULTS: 25 patients were included with a median age of 53 years (range 27-82). 39 stones were treated including 12 within the ureter, 13 in the lower pole, 13 in mid or upper poles, and 1 staghorn calculus. Median diameter for the largest stone in each patient was 9 mm (range 4-50 mm) and median Hounsfield units were 900 (range 480-1750). Both the 150 and 200 nm fibers were used with a mean laser time of 12 minutes and mean total energy of 17.1 J. Dusting technique was commonly used with pulse frequencies up to 500 Hz (table 1). Median operative time was 52 minutes. Calcium oxalate dihydrate was the most common stone composition, followed by calcium phosphate and calcium oxalate monohydrate. Complications were limited to two endoscopic grade 1 ureteral injuries related to ureteral access sheath placement, one case of renal collecting system bleeding that was adequately managed with laser coagulation settings, and one case of postoperative sepsis. All but 3 patients were discharged on their day of surgery. CONCLUSIONS: This initial case series in the United States of the Thulium Fiber Laser is promising for the treatment of urolithiasis. Sub-200 nm fibers and dusting settings up to 500 Hz were utilized successfully. No specific complications related to use of the laser were seen. Follow up with stone-free rates, larger multicentric case series, and randomized clinical trials are needed to demonstrate the efficacy of this laser. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e712-e713 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Raphael Carrera* More articles by this author Joseph Randall More articles by this author Maurilio Garcia-Gil More articles by this author Bodo Knudsen More articles by this author Ben Chew More articles by this author Jeffrey Thompson More articles by this author Mitchell Humphreys More articles by this author Wilson Molina More articles by this author Expand All Advertisement PDF downloadLoading ...