Frequently Asked Questions – Sorting the Truth from the Hype

Laser BPH

  1. What is the relevance of a laser’s wavelength?

    The wavelength of your laser fundamentally dictates the tissue interaction and it is one of the most important parameters, given it is the only feature that cannot be adjusted.  The wavelength of the Pathfinder laser is unique in that it is optimized for simultaneous soft tissue ablation and vaporization and is effective on multiple tissue types.  Superior absorption of the wavelength of light in water, which partially controls the penetration depth, also enhances safety around the bladder neck.

  1. Enucleation vs. Vaporization; which is the better treatment alternative?

    The choice of treatment alternatives is a comprehensive decision based on the experience of the clinician, the availability of resources, and the individual symptoms presented by the patient. The clinical objective of enucleation is the complete removal of the adenoma whereas vaporization selectively removes the tissue at the discretion of the surgeon. Both techniques have been proven safe and clinically effective and the Pathfinder BPH laser supports end-fire fibers for enucleation and lateral fire fibers for vaporization and has pre-set settings for both.

  1. Can laser BPH be performed in an office environment?

    Yes. Patient selection is an important criterion, however laser BPH can be performed in an office under local or general anesthetic.

  1. What are the major benefits of Office-Based Laser BPH treatments?

    - Patient acceptance, convenience, scheduling
    - Improved access to care in an outpatient setting
    - Operational efficiency (setting up and changing over the room)
    - Clinicians operational workflow, practice growth, and compensation

  1. What differentiates the Pathfinder laser from alternative BPH lasers?

    ✔ Highest output energy in its class which decreases total treatment time
    ✔ Wavelength is optimized for simultaneous vaporization & coagulation
    ✔ Unparalleled coagulation & visibility increases operational efficiency and reduces risk
    ✔ Multiple fibers and support for vaporization and enucleation with pre-set settings
    ✔ Versatility; portable and runs on 110V power hence can work in ANY room
    ✔ Cost-effective; Manufacturer Direct Pricing, hence less expensive laser, less expensive fibers, less expensive support & maintenance programs, clinical and operational training included in the purchase price, longer warranties, flexible financing; purchase, lease, placement programs, and deferred financing – more cost-effective that capital acquisition or mobilizing!

Laser Lithotripsy

  1. What is the difference between Power and Energy?

    As it relates to medical laser technology, power is an input parameter which is measured in watts. Energy is the output parameter which is measured in joules. While power is one of the components that comprise energy, it is the energy that facilitates tissue interaction, NOT just the power. The most technologically advanced and efficient lasers on the market generate maximum energy (output) with minimum power (input) which is a function of excellence in engineering. The new compact HYPHO holmium laser delivers the highest output ENERGY of ANY commercially available holmium laser on the market, yet only requires 110V power, hence can work in any room in any facility.

  1. Is higher power better?

    No. While higher power levels may enhance the interaction, you should only use the level of power you can control. The tissue interaction and overall performance as it relates to the treatment objective of laser lithotripsy is a function of multiple inputs including; wavelength, output energy, pulse duration, frequency, fiber size, and technique to name a few. While higher levels of power can support higher output energies, there is also a consideration that higher power increases the temperature of the water and the surrounding healthy (non-target) tissues, hence higher powers could increase the risk profile of the procedure.

  1. What is the relevance of pulse duration; to lithotripsy & intra-ureteral tumors?

    Pulse duration is likely one of the most important, and potentially misunderstood operational characteristics of holmium laser technology.  While marketing initiatives have typically emphasized increasing power to increase performance (which isn’t necessarily true), overall treatment time can be dramatically reduced by adjusting the pulse duration, hence increasing the stability of the target.  Its only common sense that dictates your treatment objective (fragmentation or dusting) will be more effective if the target remains stable.  Minimizing retropulsion and inadvertent stone migration is likely the single most important adjustment which can be made to decrease treatment time.  In that regard, it is universally acknowledged (and verified through clinical studies) that longer pulse durations facilitate greater stone stability and less risk of retropulsion & inadvertent stone migration. Furthermore, longer pulse durations also facilitate greater coagulation of soft tissue and enhance the versatility of the holmium laser. The new HYPHO compact holmium laser boasts the longest pulse duration of ANY holmium laser on the market.

  1. What is “dusting’ and can any laser “dust”?

    “Dusting” as it relates to laser lithotripsy is simply a more controlled, focussed/precise form of fragmentation that relies on a “photo-thermal” interaction versus the more “photo-mechanical” interaction associated with traditional fragmentation. The primary objective is to increase the photo-thermal energy, typically at the perimeter of the stone, to break down chemical bonds resulting in very small particles (“dust”) breaking away. In order to facilitate this process with a holmium (2100nm) laser, your laser must be capable of increasing the photo-thermal interaction on the target, which is either a function of: (i) increasing the frequency (Hz) or, (ii) increasing the pulse length (ms). Adequate adjustments to either will facilitate an increase in the photo-thermal interaction and stone “dusting”. An increase in power is not a requirement.

  1. What is the optimal wavelength for laser lithotripsy?

    The holmium wavelength (2100nm) is universally acknowledged as the gold standard of care for laser lithotripsy with the majority of clinical research and hundreds of thousands of successful clinical cases performed globally over the past 40+ years.

  1. What differentiates the HYPHO laser from alternative lithotripsy lasers?

    ✔ Highest output energy in its class (facilitates shorter treatment times)
    ✔ The longest pulse duration of ANY holmium laser (greater control/shorter treatment time)
    ✔ Fragmentation & Dusting capability (longest pulse of ANY holmium laser)
    ✔ Highest levels of coagulation for intra-ureteral & kidney tumors
    ✔ Pre-set settings and easy to use
    ✔ Versatility; portable and runs on 110V power hence can work in ANY room
    ✔ Cost-effective; Manufacturer Direct Pricing, hence less expensive laser, less expensive fibers, less expensive support & maintenance programs, clinical and operational training included in the purchase price, longer warranties, flexible financing; purchase, lease, placement programs, and deferred financing – more cost-effective that capital acquisition or mobilizing