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Ureteroscopic Holmium:YAG Laser Lithotripsy: Outcomes from the First 700 Consecutive Patients
Moran M, White M, Parekh A, Desai P, Mehlhaff B, Calvano C INTRODUCTION: The VersaPulse� laser offers the mid-infrared Holmium wavelength and is capable of comminuting all human concretions via a wide variety of endoscopes, flexible and semirigid. We herein report upon the results of the first 700 procedures performed over the past 36 months utilizing this laser. METHODS: The records of the operative laser utilization were tabulated and retrospective charts were reviewed for the utilization of the Coherent VersaPulse Dual Wavelength Laser. Patient age, preoperative diagnosis, post-operative diagnosis, procedure, energy settings, pulse rate, power settings, total energy delivered, all ancillary procedures, and outcomes were recorded. Any complications were recorded and separately tabulated. RESULTS: The average age of the patients in this study was 54 years (range 12-96). There were 389 males and 311 females. There were 94% unilateral and 6% bilateral ureteroscopic, 4% percutaneous nephroscopic, 2% cystoscopic and 2% steinstrasse laser lithotripsies. The fiber distribution in this series was 200 �m in 30%, 365 �m in 68%, and 500 �m in 2%. There was one postoperative surgical intervention for a mucosal bleeding vessel requiring fulguration one week later. There were 24 unsuccessful lithotripsies defined as non-stone free. CONCLUSION: The Ho:YAG laser represents a versatile energy modality for endourology that appears to be safe. An efficiency quotient for this series, defined as % stone free/ 100% + subsequent procedures was 0.92. Journal of Endourology, Vol. 13 Supplement 1, A101, Sep 1999 |
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