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Initial experience in combined ultra-mini percutaneous nephrolithotomy with the use of 120-W laser and the anti-retropulsion “Moses effect”: the future of percutaneous nephrolithotomy?

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Abstract

The purpose is to present our preliminary results where ultra-mini PCNL (UMPCNL) with the new 120-watt laser with the anti-retropulsion (Lumenis® MOSES Pulse™120H Holmium: YAG laser) was used for the first time to our knowledge. Twelve patients underwent ultra-mini PCNL in prone position under general anesthesia using a 12-F nephroscope with a 14-F Access sheath in our tertiary center. The fragmentation was performed with a 500 μm laser fiber using the 120-watt Lumenis® MOSES Pulse™120H Holmium: YAG laser). Efficacy was considered in terms of stone-free rates (SFR), complication rate, duration of the operation, and hospital stay. Our SFR was 91.6% with 11 patients out of 12 being completely free of any residual stone. The duration of the operation was 86.4 ± 36.8 (40–165) min, whereas the mean laser time (real stone fragmentation laser time) was 755.7 ± 954.7(241–3425) sec. The total laser energy used was 39.7 ± 52 KJoules (11.3–182). The fluoroscopy time and radiation doses were 358.5 ± 180.4 (154–750) sec and 64.7 ± 41.2 (14.7–159.0) mGy, respectively. The mean reduction in levels of hemoglobin postoperatively was 0.6 ± 0.3 (0.1–0.9) g/dL, and no complications were observed. The combination of UMPCNL with the new 120-watt laser and the unique anti-retropulsion technology (Lumenis® MOSES Pulse™120H Holmium: YAG laser) delivered very promising results and it could be the future of PCNL.

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Authors and Affiliations

  1. Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel

    Ioannis Leotsakos, Ioannis Katafigiotis, Amitay Lorber, Stavros Sfoungaristos, Itay M. Sabler, Vladimir Yutkin, Ofer N. Gofrit & Mordechai Duvdevani

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  1. Ioannis Leotsakos
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  2. Ioannis Katafigiotis
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  3. Amitay Lorber
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  4. Stavros Sfoungaristos
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  5. Itay M. Sabler
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  6. Vladimir Yutkin
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  7. Ofer N. Gofrit
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  8. Mordechai Duvdevani
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Correspondence to Ioannis Leotsakos.

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Leotsakos, I., Katafigiotis, I., Lorber, A. et al. Initial experience in combined ultra-mini percutaneous nephrolithotomy with the use of 120-W laser and the anti-retropulsion “Moses effect”: the future of percutaneous nephrolithotomy?. Lasers Med Sci 35, 1961–1966 (2020). https://doi.org/10.1007/s10103-020-02986-4

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  • DOI: https://doi.org/10.1007/s10103-020-02986-4

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