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Benchtop Evaluation of Miniature Percutaneous Nephrolithotomy Lithotrites.

Publication ,  Journal Article
Tabib, C; Whelan, P; Kim, C; Dionise, Z; Soto-Palou, F; Terry, R; Antonelli, J; Preminger, G; Lipkin, M
Published in: J Endourol
November 2022

Introduction: Percutaneous nephrolithotomy (PCNL) is the preferred treatment for kidney stones >2 cm. While PCNL has traditionally been performed using 24F to 30F access sheaths, there is a trend toward smaller sheaths and scopes to perform mini-PCNL (mPCNL). We performed benchtop assessment of multiple mPCNL lithotrites. Methods: One 1 cm3, hard Begostone phantom was placed in a cylinder with four 5.5 mm cylindrical openings to simulate the size of a 16.5F mPCNL sheath. Lithotripsy was performed with the 1.5 and 1.9 mm Trilogy, 1.83 mm ShockPulse, or a 200 μm Holmium:YAG (Ho:YAG) laser. Suction was used for the mechanical lithotrites. The Trilogy probes were set at 50% impact, 6 Hz, 80% ultrasound and 10% suction. The ShockPulse was used at high-power setting with low suction. The 1.9 mm Trilogy probe was used with a 15F mini-nephroscope. The 1.83 mm ShockPulse, 1.5 mm Trilogy and laser fiber were used with a 12F mini-nephroscope. The 120 W holmium laser was set at 0.5 J/70 Hz Moses-Distance. Ten independent runs were performed with modality. Time to complete stone clearance was recorded and mass stone clearance rates were calculated. Results: The Trilogy 1.9 mm showed superior stone clearance rate (11.69 ± 3.68 mg/s) vs the ShockPulse (SP) 1.83 mm (6.29 ± 1.37 mg/s, p = 0.003), the laser fiber (4.73 ± 0.61 mg/s, p < 0.0005), and the Trilogy 1.5 mm (6.84 ± 1.21 mg/s). The 200 μm laser fiber was inferior to all mechanical lithotrites. There was no difference between the 1.5 mm Trilogy and the 1.83 mm ShockPulse (p = 0.772). This translates to 3.9, 4.8, and 8.1 minutes less treatment time vs the 1.5 mm Trilogy, SP, and laser, respectively, for a spherical 1.5 cm diameter calcium oxalate monohydrate stone. Conclusion: Among these four commonly used mPCNL lithotripters, the Trilogy 1.9 mm demonstrated superior stone clearance rates in this benchtop model vs the Ho:YAG laser, 1.83 mm SP, and Trilogy 1.5 mm. Future clinical testing is warranted to evaluate the optimal lithotrite for mPCNL.

Duke Scholars

Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

November 2022

Volume

36

Issue

11

Start / End Page

1483 / 1488

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Nephrostomy, Percutaneous
  • Nephrolithotomy, Percutaneous
  • Lithotripsy
  • Kidney Calculi
  • Humans
  • Calcium Oxalate
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Tabib, C., Whelan, P., Kim, C., Dionise, Z., Soto-Palou, F., Terry, R., … Lipkin, M. (2022). Benchtop Evaluation of Miniature Percutaneous Nephrolithotomy Lithotrites. J Endourol, 36(11), 1483–1488. https://doi.org/10.1089/end.2022.0052
Tabib, Christian, Patrick Whelan, Christopher Kim, Zachary Dionise, Francois Soto-Palou, Russell Terry, Jodi Antonelli, Glenn Preminger, and Michael Lipkin. “Benchtop Evaluation of Miniature Percutaneous Nephrolithotomy Lithotrites.J Endourol 36, no. 11 (November 2022): 1483–88. https://doi.org/10.1089/end.2022.0052.
Tabib C, Whelan P, Kim C, Dionise Z, Soto-Palou F, Terry R, et al. Benchtop Evaluation of Miniature Percutaneous Nephrolithotomy Lithotrites. J Endourol. 2022 Nov;36(11):1483–8.
Tabib, Christian, et al. “Benchtop Evaluation of Miniature Percutaneous Nephrolithotomy Lithotrites.J Endourol, vol. 36, no. 11, Nov. 2022, pp. 1483–88. Pubmed, doi:10.1089/end.2022.0052.
Tabib C, Whelan P, Kim C, Dionise Z, Soto-Palou F, Terry R, Antonelli J, Preminger G, Lipkin M. Benchtop Evaluation of Miniature Percutaneous Nephrolithotomy Lithotrites. J Endourol. 2022 Nov;36(11):1483–1488.
Journal cover image

Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

November 2022

Volume

36

Issue

11

Start / End Page

1483 / 1488

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Nephrostomy, Percutaneous
  • Nephrolithotomy, Percutaneous
  • Lithotripsy
  • Kidney Calculi
  • Humans
  • Calcium Oxalate
  • 3202 Clinical sciences
  • 1103 Clinical Sciences