There are many lumpectomy urological techniques available for the treatment of urinary stones, such as extracorporeal shock wave lithotripsy (ESWL), retrograde ureterolithotripsy, percutaneous transluminal lithotripsy, and laparoscopic ureterotomy for stone extraction. Each surgical approach has its own indications, and a suitable surgical approach can be selected according to the location of the stone and individual patient differences. The success rate of ESWIL for urinary tract stones is about 57% to 90%, and it is not easy to use in the case of distal ureteral obstruction. Conventional endolithotomy (including ultrasonic lithotripsy and fluid electrolysis) requires a thicker ureteroscope (F10) and has a less than 60% clearance rate for stones in the upper and middle ureter. Open surgery is not only traumatic, but also has the disadvantage of not being able to remove stones at once and it is extremely difficult to treat stones again after recurrence. Holmium laser lithotripsy is mainly based on thermal effect. During the lithotripsy process, the water on the surface of the stone and the water in the stone absorb the energy of the holmium laser and vaporize into small spheres. Holmium laser is pulsed with an emission time of 0.25s and an instantaneous power of 10KW, which is sufficient to crush stones of various compositions and densities, with a tissue penetration depth of <0.5mm and minimal tissue damage. Holmium laser combined with endoluminal devices has become an important tool in the treatment of urinary stones. Holmium laser lithotripsy has become the first choice in the field of ureteral stone management technology because of its ability to increase the rate of complete stone removal and reduce the risk of complications. According to the European Association for Urological Technology Research Stone Management study, an average of 11.2 ureterorenoscopic laser examinations are performed per month per urology department in Northern Europe. Basic construction: As the name implies, the active medium of the holmium laser is a rare component: holmium: it can be combined with YAG crystals as HO:YAG or with yttrium-scandium-gallium-garnet (YSGG) as Ho:YSGG. various commercial models vary slightly, with pulse durations of 250350 microseconds, pulse energies of 0.2-4.0 J/pulse, frequencies of 5-45 Hz, and average energies of 3.0-80 watts. The choice of which laser to use depends on the clinical application. They both have a wavelength of 2100 nm, and it is this wavelength that gives it clinical characteristics different from other lasers. Lithotripsy principle: Holmium laser is a solid-state pulsed laser with a wavelength of 2100 nm, an invisible light, and the light is located in the near-infrared region of the spectrum. The absorption coefficient of water at this wavelength is approximately 40 cm-1, so the holmium laser can be significantly absorbed by water. Since the tissue is mainly composed of water, the holmium laser can be absorbed by the water in the body tissue and the microvoid on the surface of the stone, thus achieving good cutting and tissue ablation. It combines the characteristics of CO2 laser and neodymium laser to perform both tissue cutting and coagulation hemostasis with the same device. Holmium laser is particularly suitable for endoluminal endoscopic surgery because its wavelength can be transmitted via optical fiber. The thermal recovery time of soft tissue is 310 ms, and the holmium laser has a short pulse duration (250 microseconds) with minimal heat diffusion. This results in a "what you see is what you get" effect, making it more acceptable to surgeons. In addition to its tissue ablation properties, the holmium laser has excellent stone ablation effects. Other lasers currently used for in vivo lithotripsy are the pulsed dye laser and the varicolite laser, both of which crush stones by means of plasma-mediated shock waves. Nishioka et al. demonstrated that when a pulsed dye laser is applied directly to a stone, the small thermal effect that occurs on the surface of the stone can induce the release of large amounts of free calcium ions. These particles form clouds and mass bubbles that expand and contract with each laser pulse, and each bubble collapse produces a photoacoustic shock wave with sufficient energy to break up most urinary stones. In contrast, the exact mechanism of holmium laser lithotripsy is not known, but there is evidence that it is achieved mainly by thermal effects, with secondary shock wave and lumen formation effects. The longer pulse duration of the holmium laser produced elongated bubbles and weaker scattered shock waves compared to the powerful shock waves formed by the cavity bubbles and scattered by the pulsed dye laser. This finding was also confirmed by other researchers that when the pulse duration of the laser was increased, the cavity-forming bubbles produced by the liquid medium were elongated into a cylindrical shape, which greatly reduced the force of the secondary pressure wave compared to the spherical bubbles produced by the short-pulse laser. Therefore, the holmium laser produces relatively weak shock waves and its lithotripsy effect relies mainly on thermal effects that can lead to stone vaporization; it is conceivable that each laser pulse and heating acting on the stone surface leads to water vaporization inside and on the surface of the stone, which causes a small ablation of the stone. Once stress fractures are formed within the stone, the weaker shock waves generated by the laser also play a role in the fracturing process, causing the stone to fracture further along those slight cleavage planes. Current clinical trials support this theory. Some scientists also believe that the holmium laser works through a "drilling effect" where small stone heads are vaporized or emitted as stone powder. Holmium laser can grind stones into smaller pieces that can be more easily removed from the body. This is ideal for large ureteral stones, avoiding the need to add larger fragments with baskets or tongs. The stones can be completely disintegrated, eliminating the need to repeatedly clamp the stones in and out of the ureter and shortening the procedure time. Holmium laser can also be used for prostate enucleation or vaporization, which can be used for multiple purposes and improve the efficiency of the machine, and the holmium laser fiber can be used repeatedly, reducing the cost of using the device.