Tzelves L. et al., 2023: Innovations in Kidney Stone Removal.
Department of Urology, Sismanogleio Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Urology, Freeman Hospital, Newcastle-Upon-Tyne, UK.
Department of Urology, Warwick Hospital, Warwick, UK.
Department of Urology, Haukeland University Hospital, Bergen, Norway.
Department of Urology, University Hospital Southampton, Southampton, UK.
Urolithiasis is a common clinical condition, and surgical treatment is performed with different minimally invasive procedures, such as ureteroscopy, shockwave lithotripsy and percutaneous nephrolithotomy. Although the transition from open surgery to endourological procedures to treat this condition has been a paradigm shift, ongoing technological advancements have permitted further improvement of clinical outcomes with the development of modern equipment. Such innovations in kidney stone removal are new lasers, modern ureteroscopes, development of applications and training systems utilizing three-dimensional models, artificial intelligence and virtual reality, implementation of robotic systems, sheaths connected to vacuum devices and new types of lithotripters. Innovations in kidney stone removal have led to an exciting new era of endourological options for patients and clinicians alike.
Res Rep Urol. 2023 Apr 11;15:131-139. doi: 10.2147/RRU.S386844. eCollection 2023.PMID: 37069942
There is no doubt that technical developments have been of importance for the trend away from SWL in favor of endourology. This article is an interesting summary of recent or on-going innovations.
It needs to be emphasized that Ho:YAG laser dramatically changed the methodology for stone disintegration. Recently thulium fiber laser, TFL, has been added as a valuable tool. The retro-propulsion seen with Ho:YAG decreased significantly. In Moses technique the energy is applied in two pulses, useful for basketing as well as dusting. With the latter approach, the particles are g information for everyone who not in detail have had the possibility to follow the on-going technical development of endourology.
Urologists’ enthusiasm for using endoscopy has been the driving force for the technical development summarized in this report. Unfortunately, corresponding improvements or new ideas in SWL so far are meagre or non-existing.