Skip to main content

Advertisement

SpringerLink
Log in

Lasers in percutaneous renal procedures

  • Review
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Introduction

Since the invention of lasers in 1960, they have been increasingly used in medicine. In this review paper, the types of lasers used in urology, in addition to their applications to percutaneous renal surgery will be reviewed. Specifically, use of lasers in the percutaneous management of renal stones, upper tract transitional cell carcinoma and stricture will be reviewed.

Materials and methods

Pubmed was searched for citations since 1966. The following terms were used: “lasers”, “calculi”, “endopyelotomy”, and “transitional cell carcinoma”.

Results

Due to its minimal depth of penetration, holmium laser has proven to be safe and efficacious. It is currently the primary energy source for flexible instrumentation, and also has demonstrated efficacy in percutaneous lithotripsy (faster than ultrasonic lithotripsy and safer than electrohydraulic lithotripsy). Holmium laser been used for antegrade endopyelotomy and percutaneous resection of upper tract transitional cell carcinoma.

Conclusions

Holmium laser is safer than other lasers and has become the gold standard for laser lithotripsy for flexible instrumentation. It has been used successfully in the percutaneous management of renal stones, ureteropelvic junction obstruction, and upper tract transitional cell carcinoma. Holmium laser is an alternative energy source to conventional lithotripters and electrocautery for endopyelotomy and resection of upper tract transitional cell carcinoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Nazif OA, Teichman JM, Glickman RD, Welsch AJ (2004) Review of the laser fiber: a practical guide for urologists. J Endourol 18:818–829. doi:10.1089/end.2004.18.818

    Article  PubMed  Google Scholar 

  2. Lam JS, Gupta M (2004) Ureteroscopic management of upper tract transitional cell carcinoma. Urol Clin North Am 31:115–128. doi:10.1016/S0094-0143(03)00099-5

    Article  PubMed  Google Scholar 

  3. Luo H, Liu X, Lv S (2007) Neodymium:Yttrium aluminum garnet laser for mini-percutaneous treatment of upper urinary tract stones. J Huazhong Univ Sci Technol 27:197–199. doi:10.1007/s11596-007-0224-9

    Article  Google Scholar 

  4. Jansen ED, van Leeuwen TG, Motamedi M, Borst C, Welch AJ (1994) Temperature dependency of the absorption coefficient of water for mid-infrared laser radiation. Lasers Surg Med 14:258–264. doi:10.1002/lsm.1900140308

    Article  CAS  PubMed  Google Scholar 

  5. Sofer M, Watterson JD, Wollin TA, Nott L, Razvi H, Denstedt JD (2002) Holmium:YAG laser lithotripsy for upper urinary tract calculi in 598 patients. J Urol 167:31–34. doi:10.1016/S0022-5347(05)65376-1

    Article  PubMed  Google Scholar 

  6. Santa Cruz RW, Leveillee RJ, Krongrad A (1998) Ex vivo comparison of four lithotripters commonly used in the ureter: what does it take to perforate? J Endourol 12:417–422. doi:10.1089/end.1998.12.417

    Article  CAS  PubMed  Google Scholar 

  7. Teichman JMH, Vassar GJ, Glickman RD (1998) Holmium:yttrium-aluminum-garnet lithotripsy efficiency varies with stone composition. Urology 52:392–397. doi:10.1016/S0090-4295(98)00239-8

    Article  CAS  PubMed  Google Scholar 

  8. White MD, Moran ME, Clavano CJ, Borhan-Manesh A, Mehlfhalff BA (1988) Evaluation of retropulsion caused by holmium:YAG laser with various power settings and fibers. J Endourol 12:183–186. doi:10.1089/end.1998.12.183

    Article  Google Scholar 

  9. Lee H, Ryan RT, Teichman JMH, Kim J, Choi B, Arakeri NV, Welch AJ (2003) Stone retropulsion during holmium:YAG lithotripsy. J Urol 169:881–885. doi:10.1097/01.ju.0000046367.49923.c6

    Article  PubMed  Google Scholar 

  10. Watterson JD (2002) Safety and efficacy of holmium:YAG laser lithotripsy in patients with bleeding diatheses. J Urol 168:442–445. doi:10.1016/S0022-5347(05)64654-X

    Article  PubMed  Google Scholar 

  11. Kuo RL, Aslan P, Fitzgerald KB, Preminger GM (1998) Use of ureteroscopy and holmium:YAG laser in patients with bleeding diatheses. Urology 52:609–613. doi:10.1016/S0090-4295(98)00276-3

    Article  CAS  PubMed  Google Scholar 

  12. Teichman JMH, Rao RD, Rogenes VJ, Harris JM (1997) Ureteroscopic management of ureteral calculi: electrohydraulic versus holmium:YAG lithotripsy. J Urol 158:1357–1361. doi:10.1016/S0022-5347(01)64214-9

    Article  CAS  PubMed  Google Scholar 

  13. Matsuoka K, Iida S, Nakanami M, Koga H, Shimada A, Mihara T, Noda S (1995) Holmium:yttrium-aluminum-garnet laser for endoscopic lithotripsy. Urology 45:947–952. doi:10.1016/S0090-4295(99)80113-7

    Article  CAS  PubMed  Google Scholar 

  14. Zhong P, Tong H, Cocks FH, Pearle MS, Preminger GM (1998) Transient cavitation and acoustic emission produced by different laser lithotripters. J Endourol 12:371–378. doi:10.1089/end.1998.12.371

    Article  CAS  PubMed  Google Scholar 

  15. Rink K, Delacrétaz G, Salathé RP (1995) Fragmentation process of current laser lithotripters. Lasers Surg Med 16:134–146. doi:10.1002/lsm.1900160203

    Article  CAS  PubMed  Google Scholar 

  16. Jansen ED, Asshauer T, Frenz M, Motamedi M, Delacrétaz G, Welch AJ (1996) Effect of pulse duration on bubble formation and laser-induced pressure waves during holmium laser ablation. Lasers Surg Med 18:278–293. doi:10.1002/(SICI)1096-9101(1996)18:3<278::AID-LSM10>3.0.CO;2-2

    Article  CAS  PubMed  Google Scholar 

  17. Yates J, Zabbo A, Pareek G (2007) A comparison of the FREDDY and holmium lasers during ureteroscopic lithotripsy. Lasers Surg Med 39:637–640. doi:10.1002/lsm.20545

    Article  PubMed  Google Scholar 

  18. Scoffone CM, Cracco CM, Poggio M, Cossu M, Scarpa RM (2008) Treatment of the pyelocalyceal tumors with laser. Arch Esp Urol 61:1080–1087

    Article  PubMed  Google Scholar 

  19. Phillips CK, Landman J (2007) Lasers in the upper urinary tract for non-stone disease. World J Urol 25:249–256. doi:10.1007/s00345-007-0179-2

    Article  PubMed  Google Scholar 

  20. Orihuela E, Smith AD (1988) Percutaneous treatment of transitional cell carcinoma of the upper urinary tract. Urol Clin North Am 15:425–431

    CAS  PubMed  Google Scholar 

  21. Smith AD, Orihuela E, Crowley AR (1987) Percutaneous management of renal pelvic tumors: a treatment option in selected cases. J Urol 137:852–856

    CAS  PubMed  Google Scholar 

  22. Rastinehad AR, Ost MC, Vanderbrink BA, Greenberg KL, El-Hakim A, Marcovich R, Badlani GH, Smith AD (2009) 20-year experience with percutaneous resection of upper tract transitional carcinoma: is there an oncologic benefit with adjuvant bacillus Calmette Guérin therapy? Urology 73:27–31. doi:10.1016/j.urology.2008.06.026

    Article  PubMed  Google Scholar 

  23. Jabbour ME, Smith AD (2000) Primary percutaneous approach to upper urinary tract transitional cell carcinoma. Urol Clin North Am 27:739–750. doi:10.1016/S0094-0143(05)70122-1

    Article  CAS  PubMed  Google Scholar 

  24. Rouprêt M, Hupertan V, Traxer O, Loison G, Chartier-Kastler E, Conort P, Bitker MO, Gattegno B, Richard F, Cussenot O (2006) Comparison of open nephroureterectomy and ureteroscopic and percutaneous management of upper urinary tract transitional cell carcinoma. Urology 67:1181–1187. doi:10.1016/j.urology.2005.12.034

    Article  PubMed  Google Scholar 

  25. Soderdahl DW, Fabrizio MD, Rahman NU, Jarrett TW, Bagley DH (2005) Endoscopic treatment of upper tract transitional cell carcinoma. Urol Oncol 23:114–133. doi:10.1016/j.urolonc.2004.10.010

    PubMed  Google Scholar 

  26. Goel MC, Mahendra V, Roberts JG (2003) Percutaneous management of renal pelvic urothelial tumors: long-term follow up. J Urol 169:925–930. doi:10.1097/01.ju.0000050242.68745.4d

    Article  PubMed  Google Scholar 

  27. Lee BR, Jabbour ME, Marshall FF, Smith AD, Jarrett TW (1999) 13-year survival comparison of percutaneous and open nephroureterectomy approaches for management of transitional cell carcinoma of renal collecting system: equivalent outcomes. J Endourol 13:289–294. doi:10.1089/end.1999.13.289

    Article  CAS  PubMed  Google Scholar 

  28. Nerro RN, Claro JF, Ferreira U (1994) Is percutaneous monotherapy for staghorn calculus still indicated in the era of extracorporeal shockwave lithotripsy? J Endourol 8:195–197. doi:10.1089/end.1994.8.195

    Article  Google Scholar 

  29. Preminger GN, Assimos DG, Lingeman JE, Nakada SY, Pearle MS, Wolf JS Jr (2005) AUA Nephrolithiasis Guideline Panel. Chapter 1: AUA guideline on the management of staghorn calculi: diagnosis and treatment recommendations. J Urol 191:1991–2000

    Article  Google Scholar 

  30. Desai MR, Jasani A (2000) Percutaneous nephrolithotripsy in ectopic kidneys. J Endourol 14:289–292. doi:10.1089/end.2000.14.289

    Article  CAS  PubMed  Google Scholar 

  31. Hofmann R, Olbert P, Weber J, Willie S, Varga Z (2002) Clinical experience with a new ultrasonic and lithoclast combination for percutaneous litholapaxy. BJU Int 90:16–19. doi:10.1046/j.1464-410X.2002.02814.x

    Article  CAS  PubMed  Google Scholar 

  32. Yiu MK, Liu PL, Yiu TF, Chan AY (1996) Clinical experience with holmium:YAG laser lithotripsy of ureteral calculi. Lasers Surg Med 19:103–106. doi:10.1002/(SICI)1096-9101(1996)19:1<103::AID-LSM12>3.0.CO;2-9

    Article  CAS  PubMed  Google Scholar 

  33. Malik HA, Tipu SA, Mohayuddin N, Sultan G, Hussain M, Hashmi A, Naqvi SA, Rizvi SA (2007) Comparison of holmium:YAG laser and pneumatic lithoclast in percutaneous nephrolithotomy. J Pak Med Assoc 57:385–387

    PubMed  Google Scholar 

  34. Michel MS, Honeck MD, Alken MD (2008) New endourology technology for simultaneous Holmium:YAG laser lithotripsy and fragment evacuation for PCNL: Ex-Vivo comparison to standard ultrasonic lithotripsy. J Endourol 22:1537–1539. doi:10.1089/end.2008.0131

    Article  CAS  PubMed  Google Scholar 

  35. Jou Y, Shen C, Cheng M, Lin C, Chen P (2007) High-power holmium:yttrium-aluminum-garnet laser for percutaneous treatment of large renal stones. Urology 69:22–26. doi:10.1016/j.urology.2006.08.1114

    Article  PubMed  Google Scholar 

  36. Sun Y, Gao X, Zhou T, Chen S, Wang L, Xu C, Hou J (2009) 70 W Holmium:YAG laser in percutaneous nephrolithotomy for staghorn calculi. J Endourol (in press)

  37. Leveillee RJ, Lobik L (2003) Intracorporeal lithotripsy: which modality is best? Curr Opin Urol 13:249–253. doi:10.1097/00042307-200305000-00014

    Article  PubMed  Google Scholar 

  38. Borin JF (2008) Prone retrograde laser lithotripsy facilitates endoscope-guided percutaneous renal access for staghorn calculi: two scopes are better than one. J Endourol 22:1881–1883

    Article  PubMed  Google Scholar 

  39. Teichman JMH, Rao RD, Glickman RD, Harris JM (1998) Holmium:YAG percutaneous nephrolithotomy: the laser incident angle matters. J Urol 159:690–694. doi:10.1016/S0022-5347(01)63701-7

    Article  CAS  PubMed  Google Scholar 

  40. Vanderbrink BA, Rastinehad AR, Ost MC, Smith AD (2008) Encrusted urinary stents: evaluation and endourologic management. J Endourol 22:905–912. doi:10.1089/end.2006.0382

    Article  PubMed  Google Scholar 

  41. Somers WJ (1996) Management of forgotten or retained indwelling ureteral stents. Urology 47:431–435. doi:10.1016/S0090-4295(99)80468-3

    Article  CAS  PubMed  Google Scholar 

  42. Borboroglu PG, Kane CJ (2000) Current management of severely encrusted ureteral stents with a large associated stone burden. J Urol 164:648–650. doi:10.1016/S0022-5347(05)67272-2

    Article  CAS  PubMed  Google Scholar 

  43. Mohan-Pillai K, Keeley Fx Jr, Moussa SA, Smith G, Tolley DA (1999) Endourological management of severely encrusted ureteral stents. J Endourol 13:377–379. doi:10.1089/end.1999.13.377

    Article  CAS  PubMed  Google Scholar 

  44. Monga M, Smith R, Ferral H (2000) Percutaneous ablation of caliceal diverticulum: long-term follow up. J Urol 163:28–32. doi:10.1016/S0022-5347(05)67965-7

    Article  CAS  PubMed  Google Scholar 

  45. Donnelian SM, Harewood LM, Webb DR (1999) Percutaneous management of caliceal diverticular calculi: technique and outcome. J Endourol 13:83–88. doi:10.1089/end.1999.13.83

    Article  Google Scholar 

  46. Chong TW, Bui MH, Fuchs GJ (2000) Calyceal diverticula: ureteroscopic management. Urol Clin North Am 27:647–654. doi:10.1016/S0094-0143(05)70114-2

    Article  CAS  PubMed  Google Scholar 

  47. Auge BK, Munver R, Kourambas J, Newman GE, Preminger GM (2002) Endoscopic management of symptomatic calyceal diverticula: a retrospective comparison of percutaneous nephrolithotomy and ureteroscopy. J Endourol 16:557–563. doi:10.1089/089277902320913233

    Article  PubMed  Google Scholar 

  48. Shalhav AL, Soble JJ, Nakada SY, Wolf JS Jr, McClennan BL, Clayman RV (1998) Long-term outcome of caliceal diverticula following percutaneous endosurgical management. J Urol 160:1635–1639. doi:10.1016/S0022-5347(01)62366-8

    Article  CAS  PubMed  Google Scholar 

  49. Schwartz BF, Stoller ML (2000) Percutaneous management of caliceal diverticula. Urol Clin North Am 27:635–645. doi:10.1016/S0094-0143(05)70113-0

    Article  CAS  PubMed  Google Scholar 

  50. Kim SC, Kuo RL, Tinmouth WW, Watkins S, Lingeman JE (2005) Percutaneous nephrolithotomy for caliceal diverticular calculi: a novel single stage approach. J Urol 173:1194–1198. doi:10.1097/01.ju.0000152320.41995.c2

    Article  PubMed  Google Scholar 

  51. Ost MC, Kaye JD, Guttman MJ, Lee BR, Smith AD (2005) Laparoscopic pyeloplasty versus antegrade endopyelotomy: comparison in 100 patients and a new algorithm for the minimally invasive treatment of ureteropelvic junction obstruction. Urology 66:47–51. doi:10.1016/j.urology.2005.06.115

    Article  PubMed  Google Scholar 

  52. Brooks JD, Kavoussi LR, Preminger G, Schuessler WW, Moore RG (1995) Comparision of open and endourologic approaches to the obstructed ureteropelvic junction. Urology 46:791–795. doi:10.1016/S0090-4295(99)80345-8

    Article  CAS  PubMed  Google Scholar 

  53. Wickham JE, Kellet MJ (1983) Percutaneous pyelosis. Eur Urol 9:122–124

    CAS  PubMed  Google Scholar 

  54. Badlani G, Eshghi M, Smith AD (1986) Percutaneous surgery for ureteropelvic junction obstruction (endopyelotomy): technique and early results. J Urol 135:26–28

    CAS  PubMed  Google Scholar 

  55. Shalhav AL, Giusti G, Elbahnasy AM, Hoenig DM, McDougall EM, Smith DS, Maxwell KL, Clayman RV (1998) Adult endopyelotomy: impact of etiology and antegrade versus retrograde approach on outcome. J Urol 160:685–689. doi:10.1016/S0022-5347(01)62755-1

    Article  CAS  PubMed  Google Scholar 

  56. Knudsen BE, Cook AJ, Watterson JD, Beiko DT, Nott L, Razvi H, Denstedt JD (2004) Percutaneous antegrade endopyelotomy: long-term results from one institution. Urology 63:230–234. doi:10.1016/j.urology.2003.09.049

    Article  PubMed  Google Scholar 

  57. Doo CK, Hong B, Park T, Park HK (2007) Long-term outcome of endopyelotomy for the treatment of ureteropelvic junction obstruction: how long should patients be followed up? J Endourol 21:158–161. doi:10.1089/end.2006.0191

    Article  PubMed  Google Scholar 

  58. Bernardo NO, Smith AD (1999) Endopyelotomy review. Arch Esp Urol 52:541–548

    CAS  PubMed  Google Scholar 

  59. Patel RC, Newman RC (2004) Ureteroscopic management of ureteral and ureteroenteral strictures. Urol Clin North Am 31:107–113. doi:10.1016/S0094-0143(03)00092-2

    Article  PubMed  Google Scholar 

  60. Kristo B, Phelam MW, Gritsch HA, Schulam PG (2003) Treatment of renal transplant ureterovesical anastomotic strictures using antegrade balloon dilation with or without holmium:YAG endoureterotomy. Urology 62:831–834. doi:10.1016/S0090-4295(03)00655-1

    Article  PubMed  Google Scholar 

  61. Watterson JD, Sofer M, Wollin T, Nott L, Denstedt JD (2002) Holmium:YAG laser endotureterotomy for ureterointestinal strictures. J Urol 167:1692–1695

    Article  PubMed  Google Scholar 

  62. Laven BA, O’Connor RC, Steinberg GD, Gerber GS (2001) Long-term results of antegrade endoureterotomy using the holmium laser in patients with ureterointestinal strictures. Urology 58:924–929. doi:10.1016/S0090-4295(01)01396-6

    Article  CAS  PubMed  Google Scholar 

  63. Singal RK, Denstedt JD, Razvi HA, Chun SS (1997) Holmium:YAG laser endoureterotomy for treatment of ureteral structure. Urology 50:875–880

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest statement

There is no conflict of interest.

Author information

Authors and Affiliations

  1. Smith Institute for Urology, North Shore/Long Island Jewish Health System, 450 Lakeville Rd, Suite M-41, New Hyde Park, NY, 11040, USA

    Nadya M. Cinman, Sero Andonian & Arthur D. Smith

Authors
  1. Nadya M. Cinman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sero Andonian
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Arthur D. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Arthur D. Smith.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cinman, N.M., Andonian, S. & Smith, A.D. Lasers in percutaneous renal procedures. World J Urol 28, 135–142 (2010). https://doi.org/10.1007/s00345-009-0423-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-009-0423-z

Keywords

Search

Navigation