A prospective comparative study of mini-PCNL using Trilogy™ or thulium fibre laser with suction

Patil, Abhijit; Sharma, Rohan; Dm, Shah; Gupta, Ankit; Singh, Abhishek; Ganpule, Arvind; Sabnis, Ravindra; Desai, Mahesh

doi:10.1007/s00345-021-03881-5

Cited by 20 publications

(17 citation statements)

References 15 publications

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“…However, in the mentioned papers, no data of experience was documented which could explain the wide range of SFRs. Only few studies assessed the clinical efficacy of TFL during Mini-PCNL with comparable SFR to ours, but no study investigated the solid-state Thulium:YAG laser yet [ 4 , 19 , 27 , 28 ]. In this study, the dusting mode (115 Hz, 0.4 J) as well as the fragmentation mode (10 Hz, 1 J) showed a high efficacy in stone breakage.…”

Section: Discussionmentioning

confidence: 99%

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First Clinical Experience of a Novel Pulsed Solid-State Thulium:YAG Laser during Percutaneous Nephrolithotomy

Bergmann

Rosenbaum

Netsch

et al. 2023

JCM

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Introduction: Laser lithotripsy during Mini-PCNL is one treatment option in urinary stone disease. In recent years, a new era in stone treatment has been initiated with the introduction of new pulsed thulium lasers. The aim of this study was to investigate the safety and efficacy of laser lithotripsy with a new pulsed solid-state thulium:YAG laser during mini-PCNL. Materials and methods: All patients, regardless of stone size, who were treated with a Mini-PCNL using the new pulsed thulium laser were prospectively enrolled. Operation times, stone size, laser time, and laser settings were noted. The stone-free rate was assessed postoperatively with sonography and either x-ray or computed tomography as a clinical standard. The complications were analyzed using the Clavien-Dindo classification. Results: A total of 50 patients with a mean age of 52 years were included. 31 (62 %) patients were male. The average stone size was 242.3 (±233.1) mm2 with an average density of 833 (±325) Hounsfield units. The mean operating time was 30.56 (±28.65) minutes, and the laser-on-time was 07:07 (± 07:08) minutes. The most commonly used settings were 0.4 J and 115 Hz (46 W). The mean total energy for stone ablation was 14,166 (±17,131) kJ. The total stone-free rate was 84 %, with an overall complication rate of 32% according to Clavien-Dindo (grade 1: n = 9, grade 2: n = 6, 3b: n = 1). In the group of patients with singular stones (n = 25), the stone-free rate was 88%. Summary: The new pulsed solid-state Thulium:YAG laser allows a safe and effective lithotripsy during Mini-PCNL. The stone-free rates were high regardless of stone size with a comparable low rate of complications.

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Section: Discussionmentioning

confidence: 99%

“…This procedure is not suitable for hard stones, but the tissue defect is significantly smaller if the surgeon is careless [ 3 ]. A combined lithotrite device is also available and a further development includes the ability of suction during lithotripsy of fragmented stones [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

First Clinical Experience of a Novel Pulsed Solid-State Thulium:YAG Laser during Percutaneous Nephrolithotomy

Bergmann

Rosenbaum

Netsch

et al. 2023

JCM

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“…The authors reported 100% SFR and only three patients had Clavien II complications. More recently, Patil et al compared outcomes of mini-PCNL performed with TFL or Trilogy™ in a nonrandomized study [ 95 ]. Preoperative patients and stone characteristics were comparable among 30 participants in both groups.…”

Section: Discussionmentioning

confidence: 99%

Is There Still a Place for Percutaneous Nephrolithotomy in Current Times?

Lorenzis

Zanetti

Boeri

et al. 2022

JCM

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Background: Percutaneous nephrolithotomy (PCNL) and its miniaturized modifications are usually considered the standard surgical options for large (>20 mm) staghorn and infected stones. Moreover, PCNL is a viable alternative to retrograde intrarenal surgery (RIRS) for smaller stones (<20 mm) in the presence of anatomical malformations or inaccessible lower pole stones. However, due to the advancements in laser and scope technology, RIRS is expanding its indications with the potential benefits of lower complications and a shorter hospital stay. Methods: A literature search using the PUBMED database from inception to June 2022 was performed to explore the current role of PCNL in endourology. The analysis involved a narrative synthesis. Results: PCNL confirmed its role in the treatment of large and complex stones; moreover, miniaturized PCNL has become more competitive, gaining space among classic indications of flexible ureteroscopy. Conclusions: considering all the evaluated subgroups, we can conclude that PCNL is an old fascinating procedure and is here to stay.

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“…While the high-power lasers can also be used in percutaneous procedures, other lithotripters specific for this surgery have been created. A prospective comparative study of mini-PCNL using Trilogy lithotripter versus TFL in renal stones with a mean size > 2 cm showed that Trilogy achieved significantly better stone fragmentation rate ( 49 ). Regarding better learning of renal anatomy and PCNL technique, Parkhomenko et al described the use of an immersive virtual reality renal model ( 50 ).…”

Section: Commentmentioning

confidence: 99%

Will the advances in retrograde intrarenal surgery extinguish percutaneous nephrolithotomy for stones larger than 2 cm?

et al. 2023

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A prospective comparative study of mini-PCNL using Trilogy™ or thulium fibre laser with suction

Cited by 20 publications

References 15 publications

First Clinical Experience of a Novel Pulsed Solid-State Thulium:YAG Laser during Percutaneous Nephrolithotomy

First Clinical Experience of a Novel Pulsed Solid-State Thulium:YAG Laser during Percutaneous Nephrolithotomy

Is There Still a Place for Percutaneous Nephrolithotomy in Current Times?

Will the advances in retrograde intrarenal surgery extinguish percutaneous nephrolithotomy for stones larger than 2 cm?

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