EAU 2019: Miniaturized Percutaneous Nephrolithotomy with Moses Laser Lithotripsy Introduction and Objectives
Dr. Sindelfingen-Boeblingen from Sindelfingen, Germany presented a video of their mPNL technique with the use of high-power holmium laser system. The patient had multiple, medium-sized stones which were located in the pelvis, lower and middle calyxes. After puncture of collecting system under combined US and X-ray navigation and dilation of the tract, a sheath sized of 17.5F was put (MIP, size “M”). Laser lithotripsy was performed with a high-power holmium laser (Moses 120H, Lumenis, Israel). After the disintegration of the stones, “vacuum-cleaner” effect was used for removal of the fragments. Instead of creating the second tract, the surgeon approached the stone located in middle calyx by means of 15F flexible nephroscope (Karl Storz, Germany). A tubeless procedure with antegrade stenting was performed. The procedure time including placement of the ureteral catheter was 72 min. Stone-free status was proven by postop NCCT. Intra- and postoperative complications did not occur and hospital stay was 2.5 days. The antegrade stent was removed 1 week later.
The proposed technique of miniaturized PNL with use of the last generation of holmium laser seems to be safe and efficient for medium-sized stones and it can become a strong competitor to flexible URS.
Presented by: Nazem Atassi, MD, Klinikum Sindelfingen-Boeblingen, Department of Urology, Sindelfingen, Germany
Reported by: Kirill Shiranov, MD, Fellow, Department of Urology, Rostov University, Rostov on Don, Russia, Twitter: @endourologist and Zhamshid Okhunov, MD, Twitter: @OkhunovZham, Department of Urology, University of California-Irvine at the 34th European Association of Urology (EAU 2019) #EAU19, conference in Barcelona, Spain from March 15-19, 2019.