European Clinical Attitudes and Experiences of a Thulium Fiber Laser System: A Cross-Sectional, Multi-National Survey

OBJECTIVES: Holmium:yttrium-aluminum-garnet (Ho:YAG) laser technology has long been established as the gold standard for endoscopic laser lithotripsy. However, interest in and use of Thulium Fiber Laser (TFL) technology for laser lithotripsy in the field of urology has grown. This study investigated European clinical attitudes and experiences of a TFL, the SOLTIVE Premium SuperPulsed System (Olympus Corporation, Japan), for stone management procedures.

METHODS: An online, cross-sectional survey was administered to European physicians with prior SOLTIVE Premium experience for stone management procedures between June 2022 and September 2022. The survey was available in English, French, and German, with a combination of open- and closed-ended, numeric response, and Likert scale questions chosen to evaluate attitudes and experiences. Responses were collected anonymously, and complete responses analyzed using descriptive statistics. T-tests and chi-squared tests were used where appropriate, with p-values <.001 considered significant.

RESULTS: 40 physicians from 12 European countries participated. In comparison to the use of Ho:YAG lasers for stone management procedures, 90%, 89% and 79% of respondents agreed that SOLTIVE Premium facilitates reduced procedure times (32% and 24% shorter than with Ho:YAG for ureteroscopy and percutaneous nephrolithotomy [PCNL] procedures), improved stone-free rates, and a reduced need for secondary stone procedures (13% and 6% fewer than with Ho:YAG for ureteroscopy and PCNL procedures), respectively. A significant proportion of respondents, 77%, expected use of SOLTIVE Premium to lead to a reduction in per-procedure consumable use (stone baskets [96%], access sheaths [35%], and stents [19%]). The choice of technology was not expected to significantly impact the need for an overnight stay following ureteroscopy or PCNL (59% of all SOLTIVE Premium procedures, and 61% with Ho:YAG were expected to require overnight stays).

CONCLUSIONS: Among surveyed physicians with SOLTIVE Premium experience, there was a high level of agreement that the TFL technology improves resource-related outcomes compared to Ho:YAG for stone management procedures.