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Swiss LithoClast® Trilogy Lithotripter for Use in Robotic Pyelolithotomy
Micah Levy1, Chih Peng Chin1, Krishna T Ravivarapu1
1Department of Urology, Icahn School of Medicine at Mt. Sinai, New York, NY.
Introduction:
The Boston Scientific Swiss LithoClast® Trilogy lithotripter was intended for use in percutaneous nephrolithotomy. We performed, to our knowledge, the first two robotic pyelolithotomies using the Trilogy lithotripter for intracorporeal lithotripsy.
Case Description:
Two cases are presented involving a 65-year-old female with a complete left staghorn calculus and hydronephrosis secondary to a left ureteropelvic junction (UPJ) obstruction, and a 69-year-old male with a large left staghorn calculus and multiple large left sided simple renal cysts. In both cases, a robotic pyelolithotomy was scheduled for stone removal along with concurrent UPJ repair and cyst decortication respectively. Following pyeloplasty and cyst decortication respectively, and following stone visualization, the 2.4-mm Trilogy probe was inserted into the 12-mm assistant port and under direct visualization the stone was fragmented and removed using Trilogy's built-in mechanisms. Both patients were treated successfully without complications and were found to be stone-free on follow-up.
Conclusion:
The Trilogy lithotripter may be an effective tool for stone management when introduced during robotic pyelolithotomy and provides additional optionality when manual extraction poses challenges.
