Here’s an interesting article entitled “Holmium Laser Lithotripsy in the New Stone Age: Dust or Bust?”about Holmium Laser settings for URS lithotripsy, which includs many useful references. It is published on the website of NCBI (9/9/2017), which is drafted and critically revised by Aldoukhi AH, Roberts WW, Hall TL, Ghani KR. The following is an extract of the conclusion for those who are pressed for time, although taking a few moments to read this article for the full details is recommended.
“—During contact laser lithotripsy, use of high pulse energy settings leads to a greater loss in stone mass and is an important variable when using a fragmentation approach. Low pulse energy settings result in smaller fragments, and along with high frequencies, is the foundation for a dusting technique resulting in submillimeter fragments. Long pulse improves fragmentation efficiency by reducing retropulsion and may have a protective effect on laser fiber burnback. Non-contact laser lithotripsy is an end game strategy that can pulverize small stones in a calyx into fine fragments. However, not all stones are suitable for a dusting approach, and further clinical studies are needed to optimally define the role of these techniques during holmium laser lithotripsy.”
