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The broken stone basket: configuration and technique for removal
M L Gallentine1, J T Bishoff, W J Harmon
1Wilford Hall Medical Center, Lackland Air Force Base, TX 78236-5300, USA.
Journal of Endourology
|January 5, 2002
Summary
Tipless endoscopic stone baskets break easily with holmium:YAG laser lithotripsy and are safely retrieved. Tipped baskets are more resistant and difficult to extract after breakage.
Area of Science:
- Urology
- Endourology
- Laser Lithotripsy
Background:
- Endoscopic stone baskets are crucial for urinary stone retrieval.
- Holmium:YAG (Ho:YAG) laser lithotripsy is commonly used for stone fragmentation.
- Basket breakage during Ho:YAG lithotripsy can complicate stone retrieval.
Purpose of the Study:
- To evaluate the ease of breakage of various endoscopic stone baskets using Ho:YAG laser.
- To assess the configuration of broken baskets.
- To determine safe retrieval methods for fractured baskets.
Main Methods:
- Multiple endoscopic stone basket models were subjected to Ho:YAG laser energy.
- Energy required for wire breakage was recorded.
- Basket configuration and retrieval through different sheaths (7F, 8F/10F, 20F) were evaluated.
Main Results:
- Tipless baskets (N-Circle, Zero Tip) required the least energy to break (0.02-0.03 kJ).
- All baskets broke within typical intracorporeal lithotripsy energy ranges.
- Tipless baskets maintained a safer configuration and were easily retrieved through all tested sheaths; tipped baskets were not.
Conclusions:
- Endoscopic stone baskets fracture at standard Ho:YAG laser settings.
- Tipless baskets offer easier breakage and safer configurations post-fracture.
- Tipless baskets demonstrate superior retrieval success through various endoscopic sheaths compared to tipped baskets.
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