Introduction: Moses 2.0 mode allows dusting settings of 0.3 J and 120 Hz. There is little data examining clinical outcomes on stone treatment using these settings. Our objective was to describe the use of this technology and settings during percutaneous nephrolithotomy (PCNL) and ureteroscopy (URS) at a high-volume academic center. 

Methods: With institutional review board approval, we queried our clinical registry to identify consecutive patients that underwent calculi treatment using laser lithotripsy with 2.0 mode set to 0.3 J and 120 Hz between January 1, 2021, and September 2021. Patient demographics were examined in the context of total cumulative stone burden. Our primary objectives were to assess the efficiency of stone treatment by operative time, 90-days stone-free rate, and complications.  

Results: Overall, 44 patients (24 male, 20 female) underwent 60 total procedures (16 bilateral cases). There were 21 right URS, 26 left URS, six right PCNL, and seven left PCNL. One (2.3%) case resulted in an unplanned admission, with 68.2% discharged same-day and 29.5% planned admissions. Average operating room duration was one hour and 21 minutes (minimum: 31 minutes, maximum: two hours and 43 minutes) to treat a total cumulative average stone burden of 20.9 mm (interquartile range 11.3–23.8) for total average operative efficiency of 0.26 mm/minute. On computed tomography scan within six weeks postoperative, 31/35 patients (88.6%) were stone-free. At 90 days, only 1/44 patients had no imaging and 2/43 (4.7%) had residual stone. Overall, 90-day complication rate was 20.5% (two with Clavien-Dindo 1, six with Clavien-Dindo 2, one with Clavien-Dindo 3a, and none with Clavien-Dindo ≥3b).

Conclusions: In our single-center cohort of patients using holmium 2.0 mode technology (0.3 J and 120 Hz), we observed effective stone treatment with no Clavien-Dindo ≥3b complications.