IN VITRO COMPARISON OF DUSTING AND FRAGMENTATION TECHNIQUES USING HOLMIUM: YAG LASER LITHOTRIPSY: EFFICACY AND THERMAL IMPACT ASSESSMENT

Yusuf ŞENOĞLU, İsmail Eyüp DİLEK, Alpaslan YÜKSEL, Dursun BABA, Muhammet Ali KAYIKÇI

Konuralp Tıp Dergisi - 2026;18(2):151-155

Department of Urology, Marmara University, School of Medicine, İstanbul, Türkiye

 

Aim: Due to the potential risks of thermal effects during Ho:YAG laser lithotripsy, different techniques may vary in efficacy and safety. This study compares the stone fragmentation efficiency and temperature elevation associated with dusting and fragmentation techniques using the Ho:YAG laser in an experimental model. Material and Methods: Using an artificial renal calyx model, ten experimental tubes and phantom stones were prepared for each technique. Energy settings were 0.5 J -20 Hz for the dusting technique and 1 J -10 Hz for the fragmentation technique. Temperature was measured every minute for five minutes, and stone weights were assessed. Results: The fragmentation technique resulted in significantly greater stone mass reduction from the first minute onward (p < 0.001). Although the average temperature increase was higher in the dusting group, the intergroup difference was insignificant (p = 0.144). In both techniques, the thermal threshold of 43 dereceC was exceeded at the 2nd to 3rd minute. Conclusion: The findings of this study underscore the importance of choosing a technique for Ho:YAG laser lithotripsy. The fragmentation technique was more effective for stone disintegration, while the dusting technique posed a higher thermal risk. The Ho:YAG laser method directly impacts clinical success and patient safety, highlighting the need for further research and careful consideration in clinical practice.