Lithotripsy using the Rocamed TFL 60W and Lumenis Pulse 120H Holmium Laser systems, available to Urologist and stone-disease specialist Dr. Angelos Economides at the Blue Cross Medical Centre in Paphos, represents one of the most advanced technologies worldwide for the endoscopic treatment of stone disease (stones in the kidneys, ureters and bladder).
This technique is equally effective for all types of stones (even very hard stones that resist other methods) and at any location within the urinary tract (kidney, ureter, bladder).
How Lithotripsy is Performed
The procedure is performed endoscopically (via ureteroscopy or nephroscopy), without any external incision, harnessing the physical properties of laser.
The urologist inserts a thin ureteroscope or nephroscope through the urethra and bladder until precisely locating the stone. Through this instrument, a special, very thin laser optical fibre is passed, which reaches direct or close contact with the stone.
While with traditional lasers, the energy pulse meets the water surrounding the stone, creating vapour bubbles and often causing the so-called “retropulsion” effect — meaning the stone “escapes” away from the fibre — with the MOSES system this negative effect is avoided.
The MOSES system splits the laser pulse into two consecutive phases: the first, small pulse passes through the water and creates a small “pathway” (a guide bubble), and the second pulse travels through this pathway and strikes the stone directly with maximum energy efficiency.
With this technique, the stone does not “jump away” from the fibre (reducing the retropulsion effect by up to 50%), which means the surgeon does not need to “chase” the stone within the kidney, drastically reducing procedure time.
The high fragmentation power (up to 120 Watts), combined with the optimised rate of energy delivery, allows:
- Either fragmentation of the stone into larger pieces (which are removed with a special basket)
- Or “dusting”, i.e. converting the stone into fine dust that is passed naturally by the body
Treatment of Stone Disease with Thulium Fiber Laser
The Thulium Fiber Laser, via the Rocamed TFL 60W, is a modern and particularly effective technology for the endoscopic fragmentation of urinary tract stones. Compared to the classic Holmium laser, it can operate at a much higher pulse frequency and with lower energy per pulse. As a result, it achieves exceptionally fine fragmentation of the stone into microscopic particles (“dusting”), with less stone movement during laser application and greater precision. This technology allows effective treatment of stones of different composition and size, contributing to faster completion of the procedure and quicker patient recovery.
After lithotripsy is completed, a thin internal tube (a ureteral Stent / Pigtail catheter) is often temporarily placed for a few days, to ensure smooth urinary flow and the passage of small fragments. The patient usually leaves the hospital the same day or the following day.
