New technology in ureteroscopy and percutaneous nephrolithotomy
Jens Rassweiler1, Marie-Claire Rassweiler, Jan Klein
1aDepartment of Urology, SLK Kliniken Heilbronn bDepartment of Urology, Medical School Mannheim, University of Heidelberg, Heidelberg cDepartment of Urology, University of Ulm, Ulm, Germany.
Current Opinion in Urology
|December 3, 2015
Summary
New advancements in endourology, including percutaneous nephrolithotomy and flexible ureteroscopy, offer improved kidney stone treatment over extracorporeal shock wave lithotripsy, with enhanced technologies and techniques.
Area of Science:
- Urology
- Endourology
- Nephrolithiasis Management
Background:
- Extracorporeal shock wave lithotripsy (ESWL) has been a primary treatment for kidney stones.
- Recent technological progress in endourology presents viable alternatives and improvements.
Purpose of the Study:
- To review significant new technologies in retrograde intrarenal and percutaneous endoscopic surgery for nephrolithiasis.
- To compare endourological advancements with extracorporeal shock wave lithotripsy (ESWL).
Main Methods:
- Review of new technologies for renal access, including tracking systems and laser guidance.
- Analysis of miniaturization trends in percutaneous nephrolithotomy (PCNL) and flexible ureteroscopy (FURS).
- Evaluation of Ho:YAG-laser lithotripsy parameters and hydrodynamic fragment retrieval mechanisms.
Main Results:
- Novel renal access technologies include marker-based tracking, laser-guided puncture, and experimental electromagnetic/optical tracking.
- Percutaneous nephrolithotomy (PCNL) is now classified into miniaturized categories (Midi, Mini, Ultra/Super-mini, Micro-PCNL).
- Flexible ureteroscopy (FURS) improvements include digital HD video, miniaturized scopes, new retrieval tools, and robotic assistance.
Conclusions:
- Percutaneous nephrolithotomy (PCNL) and flexible ureteroscopy (FURS) are increasingly preferred for urolithiasis management over ESWL.
- Endourological procedures offer high primary success rates with minimal side effects, potentially outweighing invasiveness.
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