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Dr. Palle Osther, Professor at Department of Urology Director of Urological Research Center at Lillebaelt Hospital, Director of Urological Research Center at Lillebaelt Hospital, Kolding, Denmark

Clinical History:

  • 54-year-old female
  • Numerous spontaneous stone passages - COM
  • Recent left-sided ureteral stone
  • Persistent flank pain
  • No infections
  • CT showing large peripheral stones in lower and middle calyces in the left kidney

Technique Description:

  1. Flexible ureterorenoscopy with minimal irrigation
  2. Thulium fiber laser settings and technique

Procedure Steps:

  1. Placement of safety guidewire
  2. Placement of ureteral access sheath
  3. Inspection of collecting system
  4. Tissue cutting with thulium fiber laser
  5. Dusting/fragmenting/popcorning
  6. Inspection of ureter
  7. Placement of JJ-stent

Learning Points:

  • Inspection of calyces
  • Intra-papillary stones: to treat or not to treat
  • Thulium fiber laser settings for cutting, fragmenting, dusting and popcorning
  • When are fragments small enough for spontaneous passage?
Faculty keyboard_arrow_down
Dr. Palle Osther Director and Professor at Urological research Center Urology
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