The flashlamp-pumped, solid-state holmium:yttrium–aluminium–garnet (YAG) laser has been the laser of choice for use in ureteroscopic lithotripsy for the past 20 years. However, although the holmium laser works well on all stone compositions and is cost-effective, this technology still has several fundamental limitations. Newer laser technologies, including the frequency-doubled, double-pulse YAG (FREDDY), erbium:YAG, femtosecond, and thulium fibre lasers, have all been explored as potential alternatives to the holmium:YAG laser for lithotripsy. Each of these laser technologies is associated with technical advantages and disadvantages, and the search continues for the next generation of laser lithotripsy systems that can provide rapid, safe, and efficient stone ablation. New fibre-optic approaches for safer and more efficient delivery of the laser energy inside the urinary tract include the use of smaller-core fibres and fibres that are tapered, spherical, detachable or hollow steel, or have muzzle brake distal fibre-optic tips. These specialty fibres might provide advantages, including improved flexibility for maximal ureteroscope deflection, reduced cross section for increased saline irrigation rates through the working channel of the ureteroscope, reduced stone retropulsion for improved stone ablation efficiency, and reduced fibre degradation and burnback for longer fibre life.

在过去的20年中，闪光灯泵浦的固态：钇-铝-石榴石（YAG）激光器一直是输尿管镜碎石术的首选激光器。但是，尽管the激光在所有石材成分上都能很好地工作并且具有成本效益，但该技术仍存在一些基本局限性。较新的激光技术，包括倍频，双脉冲YAG（FREDDY），：YAG，飞秒和th光纤激光器，都已被视为可替代碎石术的laser：YAG激光器的潜在替代品。这些激光技术中的每一种都具有技术上的优势和劣势，并且继续寻找可提供快速，安全和有效的消融结石的下一代激光碎石术系统。为了更安全，更有效地在泌尿道内传输激光能量，新的光纤方法包括使用较小芯的光纤以及锥形，球形，可分离或中空的钢或带有枪口制动的远端光纤尖端的光纤。这些特殊的纤维可能具有以下优点：提高了输尿管镜最大挠度的柔韧性，减小了横截面以通过输尿管镜的工作通道提高盐水冲洗率，减少了结石的反冲以提高结石的消融效率，并减少了纤维的降解和回烧，从而延长了纤维寿命。