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Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...

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The Zeiss-loop stone extraction: minimal invasive and effective or obsolete?

Christof Börgermann1, F vom Dorp, H Sperling

  • 1Department of Urology and Urooncology, University of Essen Medical School, Hufelandstr. 55, 45122 Essen, Germany. christof.boergermann@uk-essen.de

World Journal of Urology
|June 10, 2009
PubMed
Summary

The Zeiss-loop procedure remains a viable option for removing small distal ureteral stones (<10 mm) under fluoroscopic guidance. This study suggests it can still be effective despite the prevalence of ureterorenoscopy (URS) and extracorporeal shock wave lithotripsy (ESWL).

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Area of Science:

  • Urology
  • Endourology
  • Nephrolithiasis Treatment

Background:

  • The advent of ureterorenoscopy (URS) and extracorporeal shock wave lithotripsy (ESWL) has diminished the role of traditional methods like the Zeiss-loop for ureteral stone removal.
  • Current expert opinion guidelines suggest against stone extraction without endoscopic visualization, impacting the perceived value of older techniques.

Purpose of the Study:

  • To evaluate the current position and efficacy of the Zeiss-loop procedure in ureteral stone treatment in the era of URS and ESWL.
  • To assess the success rates and complications associated with Zeiss-loop extraction for ureteral stones.

Main Methods:

  • Retrospective analysis of 253 patients treated with the Zeiss-loop for ureteral stones.
  • All Zeiss-loop extractions were performed under radiological control, with the loop fully withdrawn.

Main Results:

  • Complete stone removal was achieved in 219 out of 253 patients (96.5%).
  • The Zeiss-loop was most effective for distal ureteral stones (221 cases), with a high success rate for stones up to 10 mm.
  • Complication rates were low, with no instances of complete ureteral tear-off. Success rates for loop extraction were superior to ESWL but inferior to URS, though comparable for smaller distal stones.

Conclusions:

  • The Zeiss-loop, under fluoroscopic control, is a feasible alternative for treating small distal ureteral stones (<10 mm).
  • Despite its historical reputation, the Zeiss-loop can maintain a role in endoscopic stone management, particularly in specific clinical scenarios.