Table 2 Clinical studies
Study | Patients (SP TFL vs. Ho:YAG laser) | Laser setting | Primary outcome | Secondary outcome | Major conclusion | |
|---|---|---|---|---|---|---|
 SP TFL | Ho: YAG laser | |||||
Martov et al. [10], 2021 | 87:87 | 400 µm and 365 µm laser fibers, 1 J, 10 Hz | 400 µm and 365 µm laser fibers, 1 J, 10 Hz | The ability to effectively treat the stone | The total operation and lasering times, the degree of retropulsion and endoscopic view deterioration | The SP TFL technology is associated with considerably lower fragmentation and surgery times in comparison with the Ho: YAG technology |
Ulvik et al. [3], 2022 | 60:60 | 60W, 200 µm laser fibers, Equal initial settings in both groups: 0.4 J/6 Hz (Max setting: ureter 0.4 J at 6 Hz; and renal 0.8 J at 20 Hz) | 30 W, 200 µm laser Laser setup is the same as SP TFL | SFR | Operative time, intraoperative complications, and rates of postendoscopic ureteral stenting | The SP TFL is superior to the Ho:YAG in clearing kidney stones and reducing operative complications |
Mahajan et al. [11], 2022 | 59:66 | 60 W, 400 µm 1–1.5 J/6– 15 Hz | 35W, 550 µm Ho:YAG: 0.8– 1.2 J/10–15 Hz | SFR | Stone disintegration time, operative time, hospital stay, intra‑and postoperative complications | SP TFL has shorter stone disintegration time, operative time and higher SFR than the Ho:YAG |
Patil et al. [40], 2022 | 51:51 | 60W, 400 µm laser fibers, 0.1–1 J,100–250 Hz | 120W with MOSES technology, 365 µm laser fibers, 0.3–1.2 J, 20–80 Hz | SFR | Stone fragmentation rate, lasing time, operative time, total energy, stone fragment distribution, and perioperative complications | HPH-M and SP TFL showed similar SFR. Within constraints of the laser fiber size and energy settings, both modalities were equivalent in terms of fragmentation efficiency and proportion of dusting across stone densities |
Geavlete et al. [45], 2022 | 59:187 | High power Ho: YAG 120W with MOSES, 270 µm laser fibers. 0.15–0.5 J/30–100 Hz | 60 W, 150 µm laser fibers. 0.4 J/80 Hz | SFR | Operative time and perioperative events | SP TFL has a higher SFR compared to the Ho:YAG |
Ryan et al. [42], 2022 | 51:51 | - | - | Operative time | Cost saving | SP TFL has a significantly shorter operative time and decreased cost when compared to the standard the Ho:YAG |
Jaeger et al. [43], 2022 | 32: 93 | 0.2–3.5 J, 3–25 Hz | 0.2–3.5 J, 3–25 Hz | SFR | Operative times and complication | The SP TFL laser had a higher SFR than the low-power Ho:YAG laser without compromising operative time and safety |
Delbar et al. [44], 2023 | 100:76 | – | – | SFR | Complication rates and results regarding the cumulative stone size | SP TFL and Ho:YAG lithotripsy are comparable in terms of the SFR and safety for the treatment of UUT lithiasis. According to this study, for a cumulative stone size of 1–2 cm, TFL is more effective than the Ho:YAG |
Candela et al. [47], 2023 | 97:29 | Dusting (0.2 J × 200 Hz) fragmentation (1.2 J × 50 Hz) | Dusting (0.4 J × 40 Hz) popdusting/fragmentation (1.2 J × 20 Hz) | Intra-and postoperative complications | Operative time, SFR and reintervention rate | Both laser technologies are safe and effective and showed similar SFR. SP TFL showed less operative time and lower re-intervention rate compared to  the Ho:YAG laser |
Taratkin et al. [39], 2023 | 32:28 | 200 µm laser, fragmentation (1.5 J*20 Hz), dusting (0.5* 30 Hz), popcorning (0.15 J*100 Hz) fibers, surgeons could adapt the regimen to their own needs if necessary | Laser fibers and laser setup is the same as SP TFL | Laser on time, ablation speed, ablation efcacy, energy consumption | Radiation exposure time, operation time, complication rates, blood loss, duration of catheterization and SFR | SP TFL laser is a safe and efective procedure. SP TFL can decrease the laser on time and total energy for stone ablation in RIRS compared to the Ho:YAG. The SFR and complication rates are comparable for both lasers |
Haas et al. [46], 2023 | 52:52 | 60W, 200 µm laser fibers. Equal initial settings in both groups: fragmentation 0.8 J/8 Hz and dusting 0.3 J/ 80 Hz | 120W with MOSES, 200 µm laser fibers. Laser setup is the same as SP TFL | Laser-on time | SFR, complications | The two lasers showed no significant clinical advantage of one technology over the other in ureteroscope time, SFR, or complications |
Vergamini et al. [41], 2024 | 49:51 | 60W, 1.0 J and 20 Hz, short pulse. surgeons could adapt the regimen to their own needs if necessary | 120W with MOSES technology, 1.5 J and 30 Hz, with MOSES distance mode. surgeons could adapt the regimen to their own needs if necessary | SFR | Residual stone volume, ablation efficiency and speed. We hospital stay, intra-operative bleeding, changes in GFR | The Ho:YAG laser with MOSES technology and SP TFL are excellent choices for laser lithotripsy, with similar SFRs and comparable, low complication rates. The Ho:YAG laser showed a shorter operating time and greater intra-operative laser efficiency |