Evaluating Noise Emissions of Endourological Lasers: A Comparative Analysis of Ho:YAG, Tm:YAG, and Thulium Fiber Laser Systems
Stefano Moretto, Alberto Quarà, A. Madden, Johan Cabrera, Federico Zorzi, Alejandra Bravo‐Balado, Mariela Corrales, Luigi Candela, Berthe Laurent, Steeve Doizi, Frédéric Panthier, Olivier Traxer
Abstract
OBJECTIVE: To evaluate the noise levels of Holmium:YAG (Ho:YAG), Thulium Fiber (TFL), and pulsed Thulium:YAG (p-Tm:YAG) lasers across various settings, focusing on compliance with safety thresholds and potential impact on communication in the operating room (OR). MATERIALS AND METHODS: Noise measurements were taken in an empty OR using sound meters placed 1 m from the laser source. Ambient noise, standby, ready, and lasering modes at three settings (0.2 J-50 Hz, 0.5 J-20 Hz, and 1 J-10 Hz) were measured. Background noise was adjusted logarithmically, and sound emissions were weighted on dBA. Eleven laser models across Ho:YAG, TFL, and p-Tm:YAG systems were analyzed using descriptive and inferential statistics. RESULTS: Noise levels varied significantly by system and setting. All lasers produced <55dBA during standby/ready modes. During lasering, the Rocamed MH01 (Ho:YAG), RevoLix (Tm:YAG), and IPG Urolase PRO (TFL) were the quietest. The Quanta Cyber Magneto (Ho:YAG), Dornier Thulio (Tm:YAG), and EMS Laserclast (TFL) reached the highest noise levels, up to 66.06dBA. All lasers complied with NIOSH (85dBA) and OSHA (90dBA) limits, though several exceeded the 55dBA threshold for high-concentration tasks. CONCLUSION: Endourological lasers produce <55dBA in standby/ready modes but may exceed this during lasering, potentially impacting communication and focus in the OR. While occupational noise risks are minimal, attention to noise emissions is crucial for optimizing surgical team performance. Future studies should explore noise impact on surgical outcomes.