Outcomes of Ureteroscopy and Laser Stone Fragmentation (URSL) for Kidney Stone Disease (KSD): Comparative Cohort Study Using MOSES Technology 60 W Laser System versus Regular Holmium 20 W Laser

Pietropaolo, Amelia; Hughes, Thomas; Mani, Mriganka; Somani, Bhaskar

doi:10.3390/jcm10132742

Cited by 29 publications

(27 citation statements)

References 26 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In-vitro and in-vivo studies have found that MOSES technology improves significantly the ablation rate, reduces retropulsion [9] and improves the pop-corn noncontact lithotripsy technique [10]. In clinical practice using MOSES laser technology reduces significantly the operative time [11] and improves the stone-free rate [12 ▪ ,13].…”

Section: Laser Technologiesmentioning

confidence: 99%

The future of laser technology in kidney stones

Kallidonis

Vagionis

2022

Current Opinion in Urology

View full text Add to dashboard Cite

Purpose of reviewThe aim of this study was to present the recent and promising innovations of the new laser technologies used for the treatment of renal stones. Recent findingsTaking advantage of pulse modulation, new technologies such as the Moses effect, the Virtual basket and the Vapor tunnel have been introduced. These technologies seem to improve lithotripsy efficacy by reducing retropulsion and increasing the stone ablation rate. High-power laser lithotripsy has arisen in everyday clinical practice in some centres. The combination of equal efficacy and safety levels compared with the low-power laser lithotripsy and significantly reduced operative time could explain this trend. Thulium fibre laser is an innovative type of laser-emitting machine that offers a lot of advantages compared with its predecessors. The different mechanism of creating the laser pulse offers new possibilities in laser lithotripsy and perhaps in the future thulium fibre laser could replace Ho:YAG as the golden standard for laser lithotripsy.

show abstract

Section: Laser Technologiesmentioning

confidence: 99%

The future of laser technology in kidney stones

Kallidonis

Vagionis

2022

Current Opinion in Urology

View full text Add to dashboard Cite

show abstract

“…In two URS studies, Moses 1.0 was compared to the regular mode of a LP Ho:YAG laser [ 18 , 19 ]. The LP Ho:YAG lasers used in these studies were the Dornier Medilas ® H20 [ 18 ] and the Lumenis Holmium 20 W laser [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

Moses and Moses 2.0 for Laser Lithotripsy: Expectations vs. Reality

Corrales

Sierra

Traxer

2022

JCM

View full text Add to dashboard Cite

Moses technology was born with the aim of controlling the Moses effect present in every single Ho:YAG laser lithotripsy. The capacity to divide the energy pulse into two sub-pulses gained popularity due to the fact that most of the energy would be delivered in the second pulse. However, is this pulse modulation technique really better for endocorporeal laser lithoripsy? A review of the literature was performed and all relevant clinical trials of Moses 1.0 and 2.0, as well as the lab studies of Moses 2.0 carried out up to June 2022 were selected. The search came back with 11 clinical experiences (10 full-text clinical trials and one peer-reviewed abstract) with Moses 1.0 and Moses 2.0, and three laboratory studies (peer-reviewed abstracts) with Moses 2.0 only. The clinical experiences confirmed that the MT (1.0) has a shorter lasing time but lower laser efficacy, because it consumes more J/mm3 when compared with the LP Ho:YAG laser (35 W). This gain in lasing time did not provide enough savings for the medical center. Additionally, in most comparative studies of MT (1.0) vs. the regular mode of the HP Ho:YAG laser, the MT did not have a significant different lasing time, operative time or stone-free rate. Clinical trials with Moses 2.0 are lacking. From what has been published until now, the use of higher frequencies (up to 120 Hz) consumes more total energy and J/mm3 than Moses 1.0 for similar stone-free rates. Given the current evidence that we have, there are no high-quality studies that support the use of HP Ho:YAG lasers with MT over other lasers, such as LP Ho:YAG lasers or TFL lasers.

show abstract

“… Forest plot of the meta-analysis comparing post-operative complications between Moses versus regular pulse modulation [ 18 , 35 , 37 , 38 ]. …”

Section: Figurementioning

confidence: 99%

New Generation Pulse Modulation in Holmium:YAG Lasers: A Systematic Review of the Literature and Meta-Analysis

Sánchez-Puy

Bravo‐Balado

Diana

et al. 2022

JCM

View full text Add to dashboard Cite

(1) Background: New pulse modulation (PM) technologies in Holmium:YAG lasers are available for urinary stone treatment, but little is known about them. We aim to systematically evaluate the published evidence in terms of their lithotripsy performance. (2) Methods: A systematic electronic search was performed (MEDLINE, Scopus, and Cochrane databases). We included all relevant publications, including randomized controlled trials, non-randomized comparative and non-comparative studies, and in-vitro studies investigating Holmium:YAG lithotripsy performance employing any new PM. (3) Results: Initial search yielded 203 studies; 24 studies were included after selection: 15 in-vitro, 9 in-vivo. 10 In-vitro compared Moses with regular PM, 1 compared Quanta’s, 1 Dornier MedTech’s, 2 Moses with super Thulium Fiber Laser, and 1 compared Moses with Quanta PMs. Six out of seven comparative studies found a statistically significant difference in favor of new-generation PM technologies in terms of operative time and five out of six in fragmentation time; two studies evaluated retropulsion, both in favor of new-generation PM. There were no statistically significant differences regarding stone-free rate, lasing and operative time, and complications between Moses and regular PM when data were meta-analyzed. (4) Conclusions: Moses PM seems to have better lithotripsy performance than regular modes in in-vitro studies, but there are still some doubts about its in-vivo results. Little is known about the other PMs. Although some results favor Quanta PMs, further studies are needed.

show abstract

Outcomes of Ureteroscopy and Laser Stone Fragmentation (URSL) for Kidney Stone Disease (KSD): Comparative Cohort Study Using MOSES Technology 60 W Laser System versus Regular Holmium 20 W Laser

Cited by 29 publications

References 26 publications

The future of laser technology in kidney stones

The future of laser technology in kidney stones

Moses and Moses 2.0 for Laser Lithotripsy: Expectations vs. Reality

New Generation Pulse Modulation in Holmium:YAG Lasers: A Systematic Review of the Literature and Meta-Analysis

Contact Info

Product

Resources

About