2. UroToday Home
  3. Video Lectures
  4. Endourology Today

Dual Laser Lithotripsy: A New Concept for More Efficient Stone Fragmentation "Presentation" - Helen Gao

June 2, 2026

At the World Congress of Endourology and Uro-Technology, Helen Gao presents bench data on synchronized dual-fiber thulium laser lithotripsy. She tests whether simultaneously activating two 200-micron fibers improves stone ablation over single-fiber configurations. Fiber spacing was varied from 0 to 1.0 mm against a Bego stone slab, with ablation efficiency measured by 3D optical microscopy across 30-second linear passes. A spacing of 0.25 mm produced fourfold greater ablation efficiency than a single fiber at equivalent energy.

Biographies:

Helen Gao, LIFT Fellow, Department of Urology, University of California, Irvine, Orange, CA

Related Content:

Comparison of Dual Lumen Versus Single Lumen Flexible Ureteroscopes in Proximal Ureteral and Renal Stone Management - Rohit Bhatt

AUA 2024: A Randomized Control Trial Assessing Renal Damage Caused by New High Power Lasers During Ureteroscopic Laser Lithotripsy
Read the Full Video Transcript

Helen Gao: Thulium fiber laser lithotripsy has become increasingly popular due to its high ablation efficiency and minimal retropulsion. To date, all lithotripsy techniques employ a single laser fiber. In this study, we explored whether simultaneously activating two laser fibers could enhance stone ablation.

We submerged and secured a 12 by 4 by 1 centimeter Bego stone slab in saline. Using a motorized XYZ stage, 200 micron TFL fibers were secured in a 3D printed-holder with spacing between the fibers set at 0, 0.25, 0.5, 0.75, and 1.0 millimeters. Both fibers were simultaneously fired perpendicular to the stone surface at a distance of 0.5 millimeters and a one joule and 10 hertz for a total of 20 watts. For our control, we used single fibers at one joule and 10 hertz, or 10 watts, and one joule in 20 hertz, or 20 watts.

For each configuration, a three centimeter linear ablation was completed across the stone slab at a speed of one millimeter per second for 30 seconds. Each test was repeated three times.

We analyzed the ablated area of the stone using 3D optical microscopy and calculated ablation efficiency.

Ablation efficiency was highest with 0.25 millimeter fiber spacing, producing four times the ablation efficiency of a single laser fiber at the same energy. High speed photography revealed a synergistically augmented laser bubble, specifically at the 0.25 millimeter spacing.

Using a Bego stone model, synchronized dual fiber laser lithotripsy at a spacing of 0.25 millimeters resulted in a fourfold increase in ablation depth and fragmentation efficiency.

Thank you.