- May 19, 2020
- Posted by: Prof Dr Coşkun Şahin
- Category: Kidney Diseases
What is Holmium Laser?
Holmium laser is a high technological beam used in prostate surgeries and treatment of kidney stones in urological practice.
Holmium laser machine and fiber glass cable where laser energy is transmitted to stone.
What is Flexible Ureterorenoscopy?
Flexible ureterorenoscopy is a technology that has been developing rapidly in the last five years and provides access to the kidneys through the body’s natural cavities (urinary canal). It has a flexible structure. It provides access to all cavities of the kidney. It is an instrument with an optical system through which the laser probe and stone capture baskets can pass. It is used for both diagnostic and therapeutic purposes.
Flexible ureteroscopy is a flexible, flexible optical instrument that allows access to all cavities of the kidney. Washing water passes through the channel inside for image. The stones are broken by passing the laser cable from the other channel.
Which kidney stones do not require treatment?
Small stones that do not cause pain and infection, are not harmful to the kidney, located in the lower urine collection pools of the kidney do not require treatment.
Which kidney stones should be treated?
Stones that cause pain and swelling in the kidney, infectious, potential to impair kidney function at the moment or in the future require treatment.
I have kidney stones, but by which method should I be treated?
In the treatment of kidney stones, one or more of the following methods are used, respectively.
ESWL (External shock breaking stone): In this method, stones smaller than 2 cm can be broken. The stone clearance rate is ‘70% on average. Requires sessions. It should not be tried more than 3 sessions.
PNL (Percutaneous nephrolithotomy): In the operating room, 1 cm hole from the back area is entered into the kidney, and the stone is broken and the pieces are taken out. It can be applied to any size stone. Bleeding and loss of kidney parenchyma are disadvantages.
Open Surgery: It is rarely used today. It is used in patients with large stones that fill the kidney completely or kidney outflow stenoses that require repair together.
Flexible Ureterorenoscopic Lithotripsy with holmium laser
Who is suitable for Holmium laser fragmentation?
It can be applied to any stone smaller than 3 cm in the kidney or urinary tract. The fact that the stone is hard or not broken in the ESWL method does not constitute an obstacle. It is the ideal method in patients with bleeding disorders and other methods. It is also the ideal method for patients who do not want the integrity of the body to be impaired.
Who is not suitable for Holmium laser fragmentation?
It may not be suitable for patients with high stone burden. These patients can be administered in two sessions. It may not be suitable for patients with urinary tract stenosis and problems with delivery of the device to the kidney.
How does the stone fragmentation process with Holmium laser work?
It is performed under general anesthesia in operating room conditions. Patients do not feel pain during the procedure. Depending on the size of the stone, the processing time can vary from 1-3 hours. During the process, the stone is directly exposed and the stone is turned into powder with the laser energy directed by the laser probe to the stone under the optical image. A temporary stent is placed between the kidney and the bladder in large stones and in patients where the procedure takes a long time. Thus, patients spend the post-operative process comfortably.
What are the advantages of stone fragmentation with Holmium laser?
Less pain, shorter hospital stay, bleeding, without disrupting the body integrity are the advantages of entering the body through the natural entrance (urinary canal).
Are there any side effects of stone fragmentation with Holmium laser?
It has no obvious side effects when it is performed by experienced specialists. Failure to reach the stone in surgery can be rare.
How many days do I stay in the hospital?
Patients are discharged on the same day or the next day.
Do I have pain after surgery?
Pain associated with kidney stone decreases or disappears. There is a burning and urination sensation that lasts for several hours.
How can I be stone free?
Most of the stones are taken out in powder form during the process. If some are placed, it falls silently from the edge of the catheter. Do they fall off after a catheter is pulled.
Is there any unbroken stone in Holmium laser method?
All kinds of hard stones are broken with this method.
What is the cost of this method?
In this method, advanced technological tools and consumables are used. Prices may vary according to the hospital and physician. The price is determined by the size, number, location and degree of difficulty during the examination.