Category: Stones: PCNL

VS1-3 - Сlinical study on Superpulse Thulium Fiber Laser for Lithotripsy

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

Introduction & Objective :

This study aimed to analyze the first results of a clinical application of the native Tm: fiber Urolaz laser (STA IRE-Polyus, Russia) for ureteroscopy and minipercutaneous nephrolithotomy (mini-PCNL).

Methods : The study included 182 patients who underwent URS & PCNL with thulium laser lithotripsy of 182 stones of the upper urinary tract between June and January 2017.129 patients had with kidney stones while 47 and 6 patients had ureteral and urinary bladder stones, respectively. 21 (mean stone size 19±3 mm, mean density 970 HU) kidney stones were removed by retrograde intrarenal surgery (RIRS) using flexible ureteropyeloscope and thulium laser; 47 stones (mean stone size 9 ± 4 mm, mean density 1060 HU) with in various ureteral location were removed using contact thulium laser ureterolithotripsy; 97 (mean stone size 28 ± 6 mm, mean density 1670 HU) stones were removed during and 6 (mean stone size 25±3 mm, mean density 940 HU) stones were destroyed during thulium laser cystolithotripsy. 

Results :

The patients, who underwent rigid URSL, had average surgery time and hospital stay length of 23.66 ±4 min and  2±1 day, respectively, with 1st-month stone-free rate being 100%. Those patients, who underwent mini-PCNL, had average surgery time and hospital stay length of 20.66 ±4 min and 4±1 day, respectively, with 1st-month stone-free rate being 99%. No postoperative complications with more than II grade (Clavien-Dindo) were observed. In those patients, who underwent cystolithotripsy, mean surgery time was 16 ±3 min.

Conclusions :

"Urolaz" is a universal thulium laser system associated with a significant improvement in treatment effectiveness in all stone locations and a significant reduction of the likelihood of intraoperative trauma and postoperative complications. Therefore, its use may contribute to improving the quality of specialized urological care.

Stanislav Ali

Sechenov university
Moscow, Astrakhan', Russia

phd in urological department of sechenov university. in Moscow state medical university

Leonid Rapoport

Deputy Director
RI for Uronephrology, Sechenov University
Moscow, Moskva, Russia

Dmitrii Tsarichenko

Moscow, Moskva, Russia

Dmitry Enikeev

Deputy Director for Science
Institute for Urology and Reproductive health, Sechenov University
Moscow, Moskva, Russia

Surgical experience:
Experienced in TURP (>300 surgeries).
Experienced in upper urinary tract endosurgery (PCNL >200, RIRS >200).

2008-Present: Multiple upper and lower urinary tract surgeries;
2011-Present: HoLEP (400 surgeries);
2011-Present: En-bloc enucleation of bladder tumor (50 surgeries);
2016-Present: ThuLEP (>400 surgeries);
2016-Present: Thulium en-bloc enucleation of bladder tumor (>80 surgeries);
2016-Present: Brachytherapy (>40 surgeries); prostate cryoablation (70 surgeries), renal cancer cryoablation (30 surgeries);
Apr 2017-Present: Irreversible electroporation (10 surgeries);
Apr 2017-Present: MR-fusion prostate biopsy (80 procedures).

Nikolai Sorokin

Moscow, Moskva, Russia

Gagik Akopyan

Moscow, Moskva, Russia

Alim Dimov

Moscow, Moskva, Russia

Roman Klimov

Moscow, Moskva, Russia

Vladimir Lekarev

Sechenov University
Moscow, Moskva, Russia

Dmitrii Korolev