Thulium fiber laser: the new player for kidney stone treatment? A comparison with Holmium:YAG laser.
Olivier Traxer, Etienne Xavier Keller
https://pubmed.ncbi.nlm.nih.gov/30729311/Actively Recruiting
Led by University of Kansas Medical Center · Updated on 2026-05-06
150
Participants Needed
1
Research Sites
N/A
Total Duration
Researchers are studying the treatment of kidney stones larger than 2cm using a procedure called mini percutaneous nephrolithotripsy miniPCNL. This procedure commonly uses laser energy to break stones, and the study compares two FDA-approved laser platforms HolmiumYAG HoYAG laser with MOSES technology and the thulium fiber laser TFL. The study aims to evaluate which laser platform provides better outcomes when combined with a new vacuum-assisted renal access sheath called ClearPetra, which allows suction during stone breaking. Participants will be randomly assigned to one of two groups. One group will have miniPCNL using the ClearPetra sheath with the HoYAG laser, while the other group will use the same sheath with the TFL laser. Both groups will undergo the miniPCNL procedure according to standard care practices. The study specifically investigates differences in stone fragmentation efficiency and surgical outcomes between these two laser technologies. During the study, participants will undergo assessments including measurement of stone lithotripsy time, total operative time, laser energy used, and laser time during the procedure. Stone-free status will also be checked 90 days after surgery. The study is conducted by the University of Kansas Medical Center and will follow participants from the start of the procedure through follow-up visits to monitor outcomes and safety throughout the trial period ending in 2027.
CONDITIONS
HoYAG vs TFL in miniPCNL With ClearPetra
J
Jane Ledesma
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University of Kansas Medical Center
Lead Sponsor
Boston Scientific Corporation
Collaborating Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | HoYAG laser (trial) | TFL laser (trial) | HoYAG laser (standard care) |
|---|---|---|---|
| What it is | Mini‑PCNL using the Holmium:YAG laser as defined in the trial | Mini‑PCNL using the Thulium fiber laser as defined in the trial | Holmium:YAG laser is the standard energy source commonly used for lithotripsy in mini‑PCNL |
| Role in trial | Used as control arm alongside TFL in randomized mini‑PCNL | Evaluated as investigational alternative to HoYAG in mini‑PCNL | Represents current standard energy source for clinical mini‑PCNL outside the trial |
| Primary use | Lithotripsy energy source during mini‑PCNL surgery | Lithotripsy energy source during mini‑PCNL surgery | Used in standard clinical mini‑PCNL as fragmentation energy |
| Procedure method | Used during mini‑PCNL via standard percutaneous access with laser lithotripsy | Used during mini‑PCNL via standard percutaneous access with laser lithotripsy | Delivered in clinical practice during mini‑PCNL with standard surgical technique |
| Evidence status | Trial to assess stone‑free rates and operative metrics | Trial to assess stone‑free rates and operative metrics compared to HoYAG | Meta‑analyses suggest TFL may yield similar or improved stone‑free outcomes versus HoYAG |
| Important risks | Not yet established in trial; safety outcomes to be compared | Not yet established in trial; safety outcomes to be compared | Evidence shows comparable complication rates between TFL and HoYAG in ureteroscopic and mini‑PCNL studies |
| Important limitations | Trial results may not generalise if surgical skill or stone characteristics vary | Operative time and energy usage differences may influence comparisons | Most supportive evidence derives from ureteroscopic lithotripsy rather than mini‑PCNL, limiting direct applicability |
| Patient impact | To be determined by trial; primary outcome is stone‑free rate and operative metrics | To be determined by trial; could include reduced operative time or radiation exposure | Established experience with HoYAG may yield predictable outcomes in mini‑PCNL |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
Duration - Day of surgery and immediate post-operative period
Participants undergo mini-percutaneous nephrolithotomy (miniPCNL) surgery using either the HoYAG laser with MOSES technology or the Thulium Fiber Laser (TFL) with the ClearPetra™ vacuum-assisted renal access sheath as part of the procedure.
1 surgery visit (in-person)
Duration - Up to 90 days
Participants are followed up to assess stone clearance and recovery after the miniPCNL procedure.
1 to 2 follow-up visits
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Olivier Traxer, Etienne Xavier Keller
https://pubmed.ncbi.nlm.nih.gov/30729311/Yang Liu, Wei Zhu, Guohua Zeng
https://pubmed.ncbi.nlm.nih.gov/33470685/Pei Li, Ziye Huang, Xia Sun...
https://pubmed.ncbi.nlm.nih.gov/34902273/University of Kansas Medical Center
Lead Sponsor
Boston Scientific Corporation
Collaborating Sponsor