Objective: To evaluate the safety, efficacy and feasibility of laser with suction device in mini-percutaneous nephrolithotomy (mini-PCNL). Methods: A retrospective study was conducted including 200 patients who underwent mini-PCNL for renal stones. All patients underwent PCNL using Electro-Medical Systems laser. In addition to the laser in 100 patients, a suction device was used (laser with suction [LWS]). In the other 100, suction device was not used (laser with no additional suction [LOS]). Mini-PCNL was performed using standard technique and Karl Storz minimally invasive PCNL-medium system was used. Primary end point was stone clearance. Results: Both the groups were comparable in terms of demographic data. Mean stone size was 15.24±5.90 mm and 16.16±5.53 mm in LWS and LOS, respectively. Mean Hounsfield unit of stone was 1285.64 and 1206.79 in LWS and LOS, respectively. Operative time was less in LWS group (56.89±19.65 min) as compared to LOS (62.01±28.81 min). At one-month follow-up, radiological complete clearance was 96% in LWS and 92% in LOS. On subgroup analysis of stones larger than 18 mm, the clearance rate was in favour of LWS (85.7% vs. 100%) and also the need for nephrostomy placement was less in LWS group. Conclusions: LWS device is safe and efficacious when used with mini-PCNL. For stones greater than 18 mm, it has a better stone free rate as compared to using no suction.
. [J]. Asian Journal of Urology, 2022, 9(1): 63-68.
Abhishek Gajendra Singh,Sundaram Palaniappan,Shrikant Jai,Gopal Tak,Arvind Ganpule,Ravindra Sabnis,Mahesh Desai. The clinical outcomes of laser with suction device in mini-percutaneous nephrolithotomy. Asian Journal of Urology, 2022, 9(1): 63-68.
Lahme S, Bichler KH, Strohmaier WL, Gotz T. Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol 2001; 40:619e24.
[2]
de la Rosette J, Assimos D, Desai M, Gutierrez Jorge, Lingeman J, Scarpa R, et al. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: Indications, complications, and outcomes in 5803 patients. J Endourol 2011; 25:11e7.
[3]
Zhu W, Liu Y, Liu L, Lei M, Yuan J, Wan SP, et al. Minimally invasive versus standard percutaneous nephrolithotomy: A meta-analysis. Urolithiasis 2015; 43:563e70.
[4]
Dauw CA, Borofsky MS, York N, Lingeman JE. A usability comparison of laser suction handpieces for percutaneous nephrolithotomy. J Endourol 2016; 30:1165e8.
[5]
Bozzini G, Verze P, Arcaniolo D, Dal Piaz O, Buffi NM, Guazzoni G, et al. A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: A multicentre experience. World J Urol 2017; 35:1967e75.
[6]
Desai MR, Kukreja RA, Desai MM, Mhaskar SS, Wani KA, Patel SH, et al. A prospective randomised comparison of type of nephrostomy drainage following percutaneous nephrostolithotomy: Large bore versus small bore versus tubeless. J Urol 2004; 172:565e7.
[7]
Kukreja R, Desai M, Patel S, Bapat S, Desai M. Factors affecting blood loss during percutaneous nephrolithotomy: Prospective study. J Endourol 2004; 18:715e22.
[8]
Mishra S, Sharma R, Garg C, Kurien A, Sabnis R, Desai M. Prospective comparative study of miniperc and standard PNL for treatment of 1 to 2 cm size renal stone. BJU Int 2011; 108:896e9.
[9]
Zengin K, Sener NC, Bas O, Nalbant I, Alisir I. Comparison of pneumatic, ultrasonic and combination lithotripters in percutaneous nephrolithotripsy. Int Braz J Urol 2014; 40:650e5.
[10]
Jackman SV, Docimo SG, Cadeddu JA, Bishoff JT, Kavoussi LR, Jarrett TW. The "mini-perc" technique: A less invasive alternative to percutaneous nephrolithotomy. World J Urol 1998; 16:371e4.
[11]
Yang Z, Song L, Xie D, Deng X, Zhu L, Fan D, et al. The new generation mini-PCNL systemdmonitoring and controlling of renal pelvic pressure by suctioning device for efficient and safe PCNL in managing renal staghorn calculi. Urol Int 2016; 97:61e6.
