Category: Clinical Stones: PCNL

MP7-6 - Prospective Randomized comparitive study between laser with suction and Olympus Shockpulse for stones upto 2.5 cms

Fri, Sep 21
10:00 AM - 12:00 PM

Introduction & Objective :

Energy source does play a vital role in the effective stone clearance in patients undergoing minperc. In dealing with stone less than 2 cms, various energy sources are available ranging from pneumatic lithoclasts to lasers. Recent addition to the armamentarium of energy sources is the Olympus Shockpulse™. 


We intend to compare Laser with suction with Shockpulse as energy sources in miniperc to manage stones less than 2.5 cms in size.


Methods :

After Institutional Review Board approval, 60 patients undergoing miniperc for renal calculi of size less than 2 cms were randomized into two groups using random number generator. Patients undergoing miniperc with Laser with suction were placed in Group 1 and those undergoing miniperc with shockpulse were grouped in Group 2. Miniperc was performed using 20 – 22 Fr Amplatz sheath and a 18 Fr Storz nephroscope. Laser lithotripsy was performed using EMS laser with suction and Shockpulse lithotripsy was performed using Olympus shockpulse device. Patient demographics, stone characteristics, intraoperative parameters, and postoperative outcomes were analyzed.


Results :

The baseline patient demographics and stone characteristics were similar in both groups. In laser with suction group, the mean stone size was 21.4 ± 2.63 mm. The average operating time was 45.42 ± 14.79 minutes and average hospital stay was 1.47 days. Average tract size was 20 Fr and stone clearance rate was 100%.


In shockpulse group, the mean stone size was 23.2 ± 2.12 mm. The average operating time was 36.27 ± 11.41 and average hospital stay was 1.56 days. Average tract size was 20 Fr and stone clearance rate was 100%.


PARAMETERS


GROUP I (Laser with suction)


GROUP II (Shockpulse)


Mean stone size (mm)


21.4 ± 2.63


23.2 ± 2.12


Total operative time (min)


45.42 ± 14.79


36.2 ± 11.4


Skin punctureto exit time(min


31 .6 ± 4.5


27.8 ± 3.7


Mean nephroscopy time (min)


20.5 ± 5.6


18.4 ± 3.2


Mean device activation time


12.1 ± 2.5


9.6 ± 2.4


Mean Likert scale for vision


4.1/5


4.3/5


Conclusions :

Both the devices are very good. While the laser with suction expedites the process, Olympus Shockpulse is slightly superior with even better vision, faster stone clearance and shorter operative times.

Sudharsan Balaji

Fellow in Endourology, Laparoscopy and Robotics
Dr.
Nadiad, Gujarat, India

I am Dr. Sudharsan Balaji, MBBS MS MRCS DNB (Urology), working as a Fellow in Endourology, laparoscopy and Robotics in Muljibhai Patel Urological Hospital, Nadiad, India. I finished my Undergraduation and Postgraduation from Stanley Medical College, Chennai in 2009 and 2013 respectively. I finished ny Urological degree from my almamater MPUH, Nadiad in 2017 and was awarded the Endourological Society Fellowship on the same year. I have 15 publications to my credit, authored 3 book chapters and associate editor of a book titled "Monograph Series in Urology - Endourology and laparoscopy". I have so far 14 national and international presentations in various urological conferences till date. I was offered a visiting Scholarship in Pediatric Urology in Cincinnati Childrens' Hospital in 2015. I have specific interests in Endourology, Transplant and Minimally invasive pediatric urology. I see myself as laparoscopic/Robotic pediatric reconstruction in the future, which is my area of interest and expertise.

Chaitanya Deshmukh

Dr.
Nadiad, Gujarat, India

Mohankumar Vijayakumar

Fellow in Endourology, Laparoscopy and Robotics
Dr.
Nadiad, Gujarat, India

Abhishek Singh

Junior consultant
Muljibhai Patel Urological Hospital
Nadiad, Gujarat, India

Arvind Ganpule

Vice Chairman
Muljibhai Patel Urological Hospital
Nadiad, Gujarat, India

Ravindra Sabnis

Chairman
Muljibhai Patel Urological Hospital
Nadiad, Gujarat, India

Mahesh Desai

Consultant Urologist and Managing Trustee
Muljibhai Patel Urological Hospital
Nadiad, Gujarat, India