학술논문
"VirtualBasket" ureteroscopic holmium laser lithotripsy: intraoperative and early postoperative outcomes.
Document Type
Academic Journal
Author
Bozzini G; Department of Urology, ASST Valle Olona, Busto Arsizio, Varese, Italy.; European Section for UroTechnology (ESUT), Arnhem, the Netherlands.; Maltagliati M; Department of Urology, ASST Valle Olona, Busto Arsizio, Varese, Italy - matteo.maltagliati90@gmail.com.; Department of Urology, New Civil Hospital - Polyclinic S. Agostino Estense, University of Modena and Reggio Emilia, Modena, Italy.; Berti L; Department of Urology, ASST Valle Olona, Busto Arsizio, Varese, Italy.; Department of Urology, New Civil Hospital - Polyclinic S. Agostino Estense, University of Modena and Reggio Emilia, Modena, Italy.; Besana U; Department of Urology, ASST Valle Olona, Busto Arsizio, Varese, Italy.; Calori A; Department of Urology, ASST Valle Olona, Busto Arsizio, Varese, Italy.; Pastore AL; Department of Urology, ICOT Latina, Sapienza University, Rome, Italy.; Gozen A; European Section for UroTechnology (ESUT), Arnhem, the Netherlands.; Department of Urology, SLK Heilbronn Hospital, Heilbronn, Germany.; Govorov A; European Section for UroTechnology (ESUT), Arnhem, the Netherlands.; Department of Urology, Moscow University, Moscow, Russia.; Liatsikos E; European Section for UroTechnology (ESUT), Arnhem, the Netherlands.; Department of Urology, University of Patras, Patras, Greece.; Micali S; Department of Urology, New Civil Hospital - Polyclinic S. Agostino Estense, University of Modena and Reggio Emilia, Modena, Italy.; Rocco B; European Section for UroTechnology (ESUT), Arnhem, the Netherlands.; Department of Urology, New Civil Hospital - Polyclinic S. Agostino Estense, University of Modena and Reggio Emilia, Modena, Italy.; Tunc L; European Section for UroTechnology (ESUT), Arnhem, the Netherlands.; Department of Urology, Gazi University, Ankara, Turkey.; Buizza C; Department of Urology, ASST Valle Olona, Busto Arsizio, Varese, Italy.
Source
Publisher: Edizioni Minerva Medica Country of Publication: Italy NLM ID: 101777299 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2724-6442 (Electronic) Linking ISSN: 27246051 NLM ISO Abbreviation: Minerva Urol Nephrol Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The "VirtualBasket" technology (Cook Medical, Bloomington, IN, USA) is the result of pulse modulation during holmium laser emission: the laser emits part of the energy to create an initial bubble, and a second pulse is emitted when the vapor bubble is at its maximum expansion, so that it can pass through the previously created vapor channel. The aim of this study was to outline the outcomes of the "VirtualBasket" technology in ureteral and renal stones.
Methods: 160 Patients were randomly assigned to holmium laser lithotripsy with or without the "VirtualBasket" technology in ureteric or renal cases (40 per 4 groups). All procedures were performed by four experienced urologists. The Quanta System Cyber Ho 100W laser generator with 365 µm fibers was used for all the ureteral cases, whereas 272 µm fibers were used for all the cases in the renal pelvis. Demographic data, stone parameters, perioperative complications and success rates were compared. A statistical analysis was carried out to assess patients' data and outcomes. All the reported P values were obtained with the two-sided exact method at the conventional 5% significance level. The degree of stone retropulsion was graded on a Likert scale from zero (no retropulsion) to 3 (maximum retropulsion).
Results: All groups were comparable in terms of age, and preoperative stone size (ureter stone size: 1.2 vs. 1.1 cm; renal pelvis stone size: 1.55 vs. 1.62 cm). Compared to the regular mode, the "VirtualBasket" technology was associated with significantly lower fragmentation time (mean time for ureteral stones: 20.4 vs. 16.1 minutes, P<0.05; mean time for renal stones: 28.7 vs. 19.8 minutes, P<0.05) and total procedural time (mean time for ureteral stones 49 vs. 35.7 minutes; mean time for renal stones 67.1 vs. 52.4 minutes). There were no significant differences in terms of energy delivered to the stones, intraoperative complications and success rate at 1 month. The "VirtualBasket" technology was associated with significantly lower retropulsion.
Conclusions: The "VirtualBasket" technology is associated with significantly lower fragmentation and procedural times. The reduced fragmentation time is a result of the significantly lower retropulsion of the stones during laser lithotripsy, which improves stone fragmentation efficiency.
Methods: 160 Patients were randomly assigned to holmium laser lithotripsy with or without the "VirtualBasket" technology in ureteric or renal cases (40 per 4 groups). All procedures were performed by four experienced urologists. The Quanta System Cyber Ho 100W laser generator with 365 µm fibers was used for all the ureteral cases, whereas 272 µm fibers were used for all the cases in the renal pelvis. Demographic data, stone parameters, perioperative complications and success rates were compared. A statistical analysis was carried out to assess patients' data and outcomes. All the reported P values were obtained with the two-sided exact method at the conventional 5% significance level. The degree of stone retropulsion was graded on a Likert scale from zero (no retropulsion) to 3 (maximum retropulsion).
Results: All groups were comparable in terms of age, and preoperative stone size (ureter stone size: 1.2 vs. 1.1 cm; renal pelvis stone size: 1.55 vs. 1.62 cm). Compared to the regular mode, the "VirtualBasket" technology was associated with significantly lower fragmentation time (mean time for ureteral stones: 20.4 vs. 16.1 minutes, P<0.05; mean time for renal stones: 28.7 vs. 19.8 minutes, P<0.05) and total procedural time (mean time for ureteral stones 49 vs. 35.7 minutes; mean time for renal stones 67.1 vs. 52.4 minutes). There were no significant differences in terms of energy delivered to the stones, intraoperative complications and success rate at 1 month. The "VirtualBasket" technology was associated with significantly lower retropulsion.
Conclusions: The "VirtualBasket" technology is associated with significantly lower fragmentation and procedural times. The reduced fragmentation time is a result of the significantly lower retropulsion of the stones during laser lithotripsy, which improves stone fragmentation efficiency.