Laughing All the Way...Ho, Ho, Holmium! (editorial)
Wolf J Jr

INTRODUCTION: Ureteroscopy is fun! The first experience of driving a ureteroscope up and down the ureter often evokes an awe-struck reaction from a junior urology resident; for me the amazement has not ceased. Ureteroscopic lithotripsy, however, is not always fun. The anticipation of breaking down and removing a ureteral calculus to leave behind a pristine ureter is often confounded by the reality of ureteral trauma, insufficient fragmentation, migrated stone fragments and poor visualization secondary to bleeding. These frustrating developments, which may preclude an optimal outcome, are infrequently noted in association with Holmium:YAG laser lithotripsy. The Holmium:YAG laser can cause significant ureteral damage but only if it is pointed directly at the ureteral wall at close range. Trauma from careful use is unlikely.

CONCLUSION: Given that the Holmium:YAG can be used for a variety of soft tissue applications in a number of surgical specialties, the overall usefulness of the Holmium:YAG laser is enormous. The potential role of the Holmium:YAG laser in practice should be considered carefully. If you have not tried it yet, you likely will be impressed. Ho, Ho, Holmium.

LJournal of Urology, Vol. 159, Number 3, 695, Mar 1998

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