Ureteral calculi: percutaneous removal using modified basket extractors and fluoroscopy

Area of Science:

• Urology
• Minimally Invasive Surgery
• Medical Device Innovation

Background:

• Ureteral calculi (stones) pose a significant clinical challenge.
• Traditional stone extraction methods have variable success rates.
• Fluoroscopic guidance is commonly used for ureteral stone removal.

Purpose of the Study:

• To introduce and evaluate two modified helical basket extractors for ureteral stone removal.
• To assess the efficacy and success rate of the novel extraction technique.
• To compare the new method's success rate with historical data.

Main Methods:

• A two-stage extraction technique using modified helical basket extractors was employed.
• Stage 1: A stiff, expandable basket with a filiform tip and coaxial catheters.
• Stage 2: A basket with two long cable ends passed from nephrostomy to urethra, enabling vesicoureteric junction dilatation and fluid/gas injection.

Main Results:

• The modified extractors achieved a 92% success rate in removing ureteral calculi in 38 patients.
• Stones were successfully removed in 35 out of 38 cases.
• Complications were primarily related to the nephrostomy site; mucosal edema was common but transient.

Conclusions:

• Modified helical basket extractors significantly enhance the success rate of ureteral stone removal.
• The two-stage approach provides a versatile and effective method for diverse stone locations and sizes.
• This technique represents a valuable advancement in the minimally invasive treatment of ureteral calculi.