Fig. 2.

Multiple approaches to pulsed laser lithotripsy have been utilized, including (a) short pulse (250-350 µs) for fragmentation, (b) long pulse (up to 1200 µs) to reduce stone retropulsion, (c) double-pulse delivery (2 x 350 µs), (d) delivery of pulse trains for a factor of 2 times increase in ablation rates, and (e) “Moses Tech” involving delivery of a low energy, short duration pulse to create a vapor bubble immediately followed by a higher energy, longer duration pulse for more efficient stone ablation, with reduced stone retropulsion as well.