Which is the best way to treat a stone on a flexible ureterorrenoscopy? | Opinion: Fragmentation

Vol. 43 (5): 798-801, September – October, 2017

doi: 10.1590/S1677-5538.IBJU.2017.05.02


DIFFERENCE OF OPINION

Alex Meller 1
1 Divisão de Endourologia e Litíase Renal e Disciplina de Urologia – Universidade Federal de São Paulo, UNIFESP/EPM, SP, Brasil

Keywords: Calculi; Lasers, Solid-State; Kidney


Since the introduction of Holmiun YAG (Ho-YAG) laser to treat kidney or ureteral stones, a dramatic change in techniques of stone treatment has occurred, especially how to adjust the ideal laser setting to achieve ideal fragmentation.
First reports of Ho-YAG laser clinical application had been focused on tissue cutting or destruction (1), but few years later, the ability to fragment stones through a thermal mechanism was demonstrated (2). The laser emission superheats water surrounding the laser fiber tip, thus creating a microscopic vaporization bubble that is able to destabilize or vaporize tissue or a stone. Based on this mechanism, the ideal energy setting to treat a stone had been discussed and evaluated….

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