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Large Intrapapillary Stones treatment using Thulium Fiber Laser
Olympus
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2021
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Description
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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:
Flexible ureterorenoscopy with minimal irrigation
Thulium fiber laser settings and technique
Procedure Steps:
Placement of safety guidewire
Placement of ureteral access sheath
Inspection of collecting system
Tissue cutting with thulium fiber laser
Dusting/fragmenting/popcorning
Inspection of ureter
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?