Introducing the Thulium Fiber Laser for Kidney Stones

BD has launched the Elyra Thulium Fiber Laser (TFL) System in the United States, introducing a new platform for lithotripsy and soft tissue applications in urology. The system is intended to improve procedural efficiency, workflow and treatment flexibility in kidney stone management while supporting soft tissue interventions. The platform is available in two configurations, Elyra and Elyra Plus, with the latter including an optional wireless footswitch.

Thulium fiber laser technology gains traction in stone management
Thulium fiber lasers have gained adoption in urology due to their ability to operate at lower pulse energies and higher frequencies than traditional Holmium:YAG systems, supporting efficient stone dusting and reducing retropulsion during lithotripsy. BD states the Elyra system is designed to support efficient stone fragmentation while reducing stone migration during procedures.

The Elyra platform incorporates an air-cooled design intended to reduce operating noise and equipment footprint compared with conventional laser systems. Additional workflow-focused features include customizable presets, quick startup and an intuitive interface for procedural setup.

Integrated workflow features target procedural efficiency
The system supports applications including lithotripsy, tissue ablation, coagulation, incision and fragmentation of renal and ureteral calculi. According to BD, early clinical use of the Elyra Plus system generated positive feedback related to usability and integrated safety functions.

BD positions the technology within its broader kidney stone care portfolio spanning access, dilation, visualization, fragmentation, stone removal and drainage. The approach reflects growing demand for integrated urology workflows rather than standalone treatment devices.

Additional Context:
Technical specifications and competitive benchmarking not included in the original announcement

Comparable thulium fiber laser platforms include Olympus’ SOLTIVE Premium, which operates at frequencies up to 2,400 Hz with energy settings between 0.025–6 J and uses air cooling similar to BD’s Elyra system.

Studies comparing thulium fiber lasers with 120 W Holmium:YAG systems found faster stone ablation rates (2.23 mg/s vs. 1.78 mg/s) and improved dusting efficiency, alongside fewer residual fragments and reduced retropulsion. Compared with conventional Holmium:YAG platforms, thulium fiber systems also support higher pulse frequencies and smaller fiber diameters, potentially improving irrigation and access in narrow anatomies.

Unlike existing platforms focused primarily on lithotripsy performance, BD emphasizes workflow optimization through interface design, startup speed and procedural customization, although quantitative comparative performance data for Elyra has not yet been publicly disclosed.

Edited by Natania Lyngdoh, Induportals editor, assisted by AI.

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