Montefiore Einstein Urology recently installed two new groundbreaking technologies—the thulium fiber laser (TFL) and the CVAC Aspiration System—which are revolutionizing the treatment of kidney stones to improve stone-free rates, stone clearance, procedural efficiencies, and overall outcomes. This recent expansion of our suite of uro-technologies offers even more personalized, minimally invasive and incisionless options to better treat our patients with large and complex kidney stones who have historically required multiple procedures or percutaneous nephrolithotomy.

The thulium fiber laser (TFL) is a novel advanced laser technology that is an alternative to the Holmium:YAG (Ho:YAG) laser, which is traditionally the gold standard for laser lithotripsy of kidney stones. Using a laser wavelength of 1940 nm, TFL energy is transferred to kidney stones four times more efficiently than with Ho:YAG  laser energy. Research findings have revealed that when used for the treatment of kidney stones, TFL has numerous potential advantages compared to the Ho:YAG laser including higher efficiency of stone ablation, superior dusting abilities, less retropulsion and potentially increased patient safety. Additionally, TFL can support smaller laser fiber sizes, allowing for improved access to hard-to-reach stones such as those in the lower pole renal calyces and enabling better visualization through existing ureteroscopes.

FDA-cleared in March 2024, the new CVAC System (Calyxo, Inc.) is an all-in-one tool that enables a minimally invasive approach for kidney stone clearance, using simultaneous irrigation and dynamic vacuum aspiration to efficiently and effectively remove small stone fragments and debris formed during ureteroscopy and laser lithotripsy. 

The prevalence of kidney stones in Americans is roughly 9%, with more than one million patients treated annually across the U.S. for kidney stone pain. Standard kidney stone treatments can include extracorporeal shock wave lithotripsy (ESWL), ureteroscopy and percutaneous nephrolithotripsy (PCNL), depending on the size, type and location of the stone and the patient’s anatomy. The goal is to be completely stone-free after a single minimally invasive procedure that can easily and reliably remove all dust and stone pieces without any residual stone fragments which could cause recurrence of symptoms, continued pain, infection and the need for additional procedures. 

The recent installation and application of these new groundbreaking technologies further highlights our commitment to developing and embracing innovation in urology to improve outcomes for patients with kidney stones. We’re an international referral site for the most complex cases and ranked in the top 1% of all hospitals in the nation for urology according to U.S. News & World Report.