A Comparative Study of Holmium: Yttrium-aluminum-garnet Laser Modes for the Fragmentation of Kidney Stones

Background: The problem of human kidney stones is currently a common disease. This is due to several variables, including nutrition, genetic factors, and geographic region. Kidney stones can be eliminated in several ways, including laser fragmentation, a safe and minimally harmful method because it does not require surgical intervention. Objectives: This study compares hard stones and dusting modes of the Holmium: Yttrium-aluminum-garnet (Ho:YAG) laser used for fragmented kidney stones. Methods: The Ho:YAG laser with a maximum power of 30 W, pulse duration 600 μs, wavelengths 2100 nm, the maximum energy level 5 J with maximum frequency level of 30 Hz, used for lithotripsy in Al-Sadr Medical City in Najaf City, Iraq, at different laser parameters energy pulse and pulse rate of 0.8 J/8 Hz and 1 J/10 Hz, respectively, for 17 samples of kidney stones. The laser is passed by the optical fiber through a thin tube (catheter) that is inserted into the ureter through the urethra to reach the stone. Results: The calcium oxalate stones are ablated more than uric acid stones at different pulse rates. In addition, the samples that fragmented by Ho:YAG laser with hard stones mode with the energy of 0.8 J and pulse rate of 8 Hz have the highest ablation rates than dusting mode, and the dusting mode with energy 0.8 J and pulse rate 8 Hz have the highest ablation rates than dusting mode with energy 1 J and pulse rate 10 Hz for calcium oxalate stones. Conclusion: Laser lithotripsy may be a more effective treatment option for calcium oxalate stones than uric acid stones.