The clinical outcomes of laser with suction device in mini-percutaneous nephrolithotomy

To evaluate the safety, efficacy and feasibility of laser with suction device in mini-percutaneous nephrolithotomy (mini-PCNL).

A retrospective study was conducted including 200 patients who underwent mini-PCNL for renal stones. All patients underwent PCNL using Electro-Medical Systems laser. In addition to the laser in 100 patients, a suction device was used (laser with suction [LWS]). In the other 100, suction device was not used (laser with no additional suction [LOS]). Mini-PCNL was performed using standard technique and Karl Storz minimally invasive PCNL-medium system was used. Primary end point was stone clearance.

Both the groups were comparable in terms of demographic data. Mean stone size was 15.24±5.90 mm and 16.16±5.53 mm in LWS and LOS, respectively. Mean Hounsfield unit of stone was 1285.64 and 1206.79 in LWS and LOS, respectively. Operative time was less in LWS group (56.89±19.65 min) as compared to LOS (62.01±28.81 min). At one-month follow-up, radiological complete clearance was 96% in LWS and 92% in LOS. On subgroup analysis of stones larger than 18 mm, the clearance rate was in favour of LWS (85.7% vs. 100%) and also the need for nephrostomy placement was less in LWS group.

LWS device is safe and efficacious when used with mini-PCNL. For stones greater than 18 mm, it has a better stone free rate as compared to using no suction.