Retrograde intrarenal surgery (RIRS) with Holmium: YAG laser and Magneto technology versus Thulium Fiber Laser: it's time to compare
In brief
Magneto laser left 94% stone-free versus 83% with thulium fiber laser
In a four-center comparison of 424 patients undergoing kidney stone surgery, the Magneto-modulated holmium laser group had a 94% stone-free rate, compared with 83% for the thulium fiber laser group. Magneto also used less energy and had higher ablation efficiency, while procedure times and complication rates were similar; whether the stone-free advantage holds in other settings remains unknown.
- Journal
- World journal of urology (Q1)
- Published
- 31 October 2026
- Study design
- Unclassified
- Evidence level
- Level 5, Expert Opinion (CEBM 5)
- Authors
- Davide Perri, Eugenio Ventimiglia, Alba Sierra, Luigi Candela, Catalina Solano, Andrea Li Puma, et al.
- PMID
- 42965696
- DOI
- 10.1007/s00345-026-06906-z
Why clinicians should know about it
- Picked for Urology (paper of the day, 4 November 2026): Comparative laser technologies for renal stone surgery
Abstract
OBJECTIVE: To compare efficacy, safety and performances of Holmium: YAG laser with Magneto pulse-modulation technology and Thulium Fiber Laser (TFL) during retrograde intrarenal surgery (RIRS). MATERIALS AND METHODS: Patients with a renal stone underwent RIRS using the Holmium: YAG Cyber Ho laser generator with Magneto technology (Group A) versus TFL (Group B) at four centers (Como, Milan, Barcelona, Paris). Operative time, lasing time, delivered energy, energy consumption (J/mm³), ablation rate (mm³/s), ablation efficiency (mm3/J), time consumption (s/mm3), stone-free rate (SFR) and complication rate were assessed and compared. RESULTS: A total of 424 patients underwent RIRS, including 202 treated with the Magneto technology and 222 with the TFL. Baseline demographic and stone characteristics were comparable between the two groups. Magneto was associated with significantly lower delivered energy (5.4 vs. 8.2 kJ, p = 0.05), lower energy consumption (20.6 vs. 23.2 J/mm³, p = 0.01), and higher laser ablation efficiency (0.12 vs. 0.07 mm³/J, p < 0.05). Operative time, lasing time, laser ablation rate, laser time consumption, hospital stay, and complication rates were comparable between groups. SFR was significantly higher in the Magneto group than in the TFL group (93.6% vs. 83.3%, p < 0.05). CONCLUSIONS: Both Magneto and TFL provided safe and effective lithotripsy during RIRS. Magneto achieved comparable ablation rate while requiring less delivered energy, improving laser ablation efficiency and providing a higher SFR.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.