Emerging Laser Techniques for the Management of Stones

Next-generation holmium laser systems provide the user with a range of parameters that can help optimize fragmentation efficiency. Ureteroscopic strategies broadly consist of fragmentation with active retrieval, or dusting, which uses low pulse energy settings to break stones into fine fragments for spontaneous passage. Techniques for dusting include dancing, chipping, and popcorning. The Moses technology is a multipulse mode that may help reduce retropulsion and increase fragmentation. The thulium fiber laser is an emerging laser technology that provides an extensive parameter range for dusting. Future studies are needed to define the role of these technologies and techniques for laser lithotripsy.