Category: Stones: Ureteroscopy

VS1-11 - Initial Experience With MOSES Laser Lithotripsy Using Lumenis Technology

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

Introduction & Objective :

Ureteroscopy has emerged as the most versatile and least invasive treatment option for patients with all stone compositions and a total stone burden less than 2cm. One of the main reasons for this advancement is the development and progression of the holmium laser technology, enabling lithotripsy of stones in any location. Multiple approaches to lithotripsy, such as dusting or basketing, are employed to treat stone disease. While basketing has been proven to have higher stone free rates, there is still utility for dusting, especially if the stone is in the ureter. Dusting a stone in the ureter is effective because gravel moves in an antegrade fashion into the bladder. One of the major drawbacks to dusting is stone retropulsion caused by the acoustic pulse of the holmium laser. To combat this, new technology developed by Lumenis using the 120-watt laser system, optimizes energy transmission and significantly reduces stone retropulsion. This new Moses technology leads to less stone migration and provides the surgeon with more control. In this video, we contrast the use of the Moses technology and the standard laser lithotripsy.

Methods :

Between 1/16/2017- 6/21/2017, 32 patients underwent laser lithotripsy using the Lumenis Pulse 120H laser system with Moses technology at IU Methodist Hospital. Video and fluoroscopic imaging was captured, and optimal cases were selected to demonstrate the Moses technology.

Results :

All patients underwent successful laser lithotripsy using Moses technology. There were no complications specifically related to the Moses laser technology.

Conclusions :

Within this video we provide clear visual evidence that Lumenisà‚€TM Moses technology reduces retropulsion and stone migration. Reduction in ureteral stone retropulsion leads to overall higher efficiency of ureteral laser lithotripsy.

Tim Large

Endourology Fellow
Indiana University School of Medicine
Indianapolis, Indiana

Name: Tim Large MD
Title: Endourology Fellow - Indiana University School of Medicine
Affiliation: IU-Methodist Hospital

I am currently in the second year of fellowship with Drs. Lingeman and Krambeck at Indiana University in Indianapolis, Indiana. We focus on the management of stones and symptomatic benign prostate hyperplasia.

Blake Anderson

Endourology Fellow
Indiana University School of Medicine
Indianapolis, Indiana

Joshua Heiman

Indianapolis, Indiana

Amy E. Krambeck

Indiana University School of Medicine
Indianapolis, Indiana