An energy-efficient, solid-state laser, the holmium: YAG laser emits light at 2100 nm. The device combines the benefits of both a carbon dioxide laser and a neodymium:YAG laser for tissue cutting and coagulation in one device. Since the holmium wavelength can be transmitted down optical fibers, it is especially suited for endoscopic surgery.
Holmium wavelengths are strongly absorbed by water. Ablation of tissue occurs superficially, with thermal injury zones from 0.5 to 1.0 mm, allowing for precise incisions. This level of coagulation is sufficient for adequate hemostasis. The holmium laser has been used for a variety of urologic applications, including incision of urethral and ureteral strictures; ablation of superficial transitional cell carcinoma; incision of the bladder neck and prostate resection; and lithotripsy of urinary calculi.
Holmium:YAG lasers serve a variety of purposes and have multiple specialties. This treatment has shown to be safe and effective for multiple soft tissue applications and stone fragmentation. The fact that it has these characteristics will cause it to be increasingly used in urology over time.