Holmium Laser lithotripsy is the breaking of urinary stone using the Holmium laser. The Holmium laser has a wavelength of 2100 nm, which is in the infrared spectrum. This wavelength is ideal for treating stones. The Holmium laser energy may be absorbed by the stone creating cracks within the stone. This laser energy is sufficient to break even the hardest stone.

The Holmium laser energy is delivered via thin fibers with various diameters to suit telescopes of different sizes. These telescopes may be rigid, metal telescopes or flexible fibreoptic type. This thin telescope called a ureteroscope is passed gently and skillfully through the natural urinary passage from the penis up the bladder into the ureter where the stone is.  This procedure is called ureteroscopy. The Holmium laser fiber can be placed in contact with the stone or adjacent to it. Short Holmium laser pulses create a shockwave that causes fragmentation of the stone. Smaller stones can be fragmented directly, whereas with larger ones, holes are punched in the center, after which the edges are chiseled away with the Holmium laser. Finally, the residual fragments can be flushed out.

Holmium Laser lithotripsy is performed under general anesthesia. The patient can be discharged after a few hours of observation.  Overnight stay in the hospital is typically not required for Holmium Laser lithotripsy.

Although extracorporeal shock wave lithotripsy (ESWL) is the most common and simplest treatment for stones, not all stones can be treated successfully with ESWL. The Holmium Laser lithotripsy is an effective alternative for stones not suitable for ESWL. Holmium Laser lithotripsy has a high success rate and low complication rate.