Ureteroscopy and lasertripsy with pop dusting using high power holmium laser for large urinary stones &gt; 15 mm: 6.5-year prospective outcomes from a high-volume stone center

Pietropaolo, Amelia; Massella, Virginia; Ripa, Francesco; Mani, Mriganka; Somani, Bhaskar K.

doi:10.1007/s00345-023-04438-4

Cited by 3 publications

(1 citation statement)

References 35 publications

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“…Particularly, temperature increases occurred with continuous laser irradiation without irrigation [37]. Furthermore, with the recent introduction of high-power lasers, some studies have reported their efficacy and safety during the procedure, particularly the dusting technique's clinical benefits [38]. However, the potential risk of laser thermal injury from the improper use of high-power lasers must be considered.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Robot-Assisted Ureteroureterostomy in Patients with Complex Ureteral Stricture after Ureteroscopic Lithotripsy

Hamamoto,

Taguchi,

Kawase

et al. 2023

JCM

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Background: Ureteral stricture (US) postureteroscopic lithotripsy (URSL) has emerged as a severe complication with the widespread use of laser technology. Furthermore, managing a complex US is challenging. Therefore, this study evaluated the efficacy of robot-assisted ureteroureterostomy (RAUU) in addressing US post-URSL and analyzed the pathology of transected ureteral tissues to identify the risk factors for US. Methods: we conducted a prospective cohort study on patients who underwent RAUU for URSL-induced US from April 2021 to May 2023. Results: A total of 14 patients with a mean age of 49.8 years were included in this study. The mean stricture length on radiography was 22.66 ± 7.38 mm. Nine (64.2%) patients had experienced failure with previous interventions. The overall success rate was 92.9%, both clinically and radiographically, without major complications, at a mean follow-up of 12.8 months. The pathological findings revealed microcalcifications and a loss of ureteral mucosa in 57.1% and 28.6% of patients, respectively. Conclusions: The RAUU technique shows promise as a viable option for US post-URSL in appropriately selected patients despite severe pathological changes in the ureter. Therefore, the migration of microcalcifications to the site of ureteral perforation may be a significant factor contributing to US development.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Robot-Assisted Ureteroureterostomy in Patients with Complex Ureteral Stricture after Ureteroscopic Lithotripsy

Hamamoto,

Taguchi,

Kawase

et al. 2023

JCM

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Comparison of conventional (basketing + dusting) and Moses (pop-dusting) holmium lasers during flexible ureteroscopy in the treatment of renal stones between 2 and 3 cm: a randomized clinical trial

Hao,

Wang,

Zheng

et al. 2024

Urolithiasis

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Comparison of lithotripsy methods during mini-PNL: is there a role for ballistic lithotripsy in the era of high-power lasers

Ibis,

Özsoy,

Özkaya

et al. 2024

BMC Urol

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Background For renal stones > 20 mm, percutaneous nephrolithotomy (PNL) offers the best stone clearance rates with acceptable complication rates. This study aimed to compare the efficiency of high-power holmium YAG laser and ballistic lithotripsy during mini-PNL. Methods Data from 880 patients who underwent mini-PNL for renal stones was investigated retrospectively. The study utilized propensity score matching to create two groups: laser lithotripsy (n = 440) and ballistic lithotripsy (n = 440). The groups were matched based on stone size, Guy’s stone score, and stone density. The main objectives of the study were to assess the stone-free rate (SFR), duration of surgery, and complication rates. Results The average age of the population was 51.4 ± 7.1 years, with a mean stone size of 28.6 ± 8.3 mm and a mean stone density of 1205 ± 159 HU. There were no significant differences between the groups. The SFRs of the laser lithotripsy and ballistic lithotripsy were 92.5% and 90.2%, respectively (p = 0.23). The laser lithotripsy group had a notably shorter surgery time (40.1 ± 6.3 min) compared to the ballistic lithotripsy group (55.6 ± 9.9 min) (p = 0.03). Complication rates were similar (p = 0.67). Conclusions Our study shows that a high-power holmium YAG laser provides quicker operation time compared to ballistic lithotripsy. However, ballistic lithotripsy is still an effective and safe option for stone fragmentation during mini-PNL. In places where a high-power holmium YAG laser is not available, ballistic lithotripters are still a safe, effective, and affordable option for mini-PNL.

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Ureteroscopy and lasertripsy with pop dusting using high power holmium laser for large urinary stones > 15 mm: 6.5-year prospective outcomes from a high-volume stone center

Cited by 3 publications

References 35 publications

Efficacy of Robot-Assisted Ureteroureterostomy in Patients with Complex Ureteral Stricture after Ureteroscopic Lithotripsy

Efficacy of Robot-Assisted Ureteroureterostomy in Patients with Complex Ureteral Stricture after Ureteroscopic Lithotripsy

Comparison of conventional (basketing + dusting) and Moses (pop-dusting) holmium lasers during flexible ureteroscopy in the treatment of renal stones between 2 and 3 cm: a randomized clinical trial

Comparison of lithotripsy methods during mini-PNL: is there a role for ballistic lithotripsy in the era of high-power lasers

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