2018-239 – Suction Device for Stone Stabilization During Ureteroscopic Laser Lithotripsy

  • Stabilizes stones during laser lithotripsy
  • Minimizes residual stone fragments
  • Enhances procedural efficiency

Abstract

Kidney stones affect 29.4 million people per year in the United States. When the stones are too large to be passed naturally, medical intervention such as ureteroscopic lithotripsy or percutaneous nephrolithotomy is required. Ureteroscopic lithotripsy either breaks up the stones into smaller pieces that can be extracted with a basket, or uses a “dusting” method which erodes the stone into sand particles < 0.5 mm. An emerging and popular technique to treat larger stones is miniaturized percutaneous nephrolithotomy (mini-PCNL), in which small tracts are inserted percutaneously into the kidney. The stone is visualized using a nephroscope and laser energy is delivered through a laser fiber with direct visualization to fragment the stones. Mini-PCNL is associated with less blood loss, is minimally invasive, and can be performed as day-case procedures without the need for hospital admission. However, mini-PCNL is still limited by stone fragment migration during treatment, which leads to increased procedural difficulty, operating room (OR) time, and residual fragments that increase risk of retreatment for patients at a later date. A recent study from a high volume center using computed tomography scans in patients after mini-PCNL reported a stone-free rate (SFR) of only 43%. Therefore, devices and techniques that improve the SFR, and lower the OR time, would have benefits for patients, surgeons, and the healthcare system.

Researchers at the University of Michigan have developed a single-use, expandable , conical suction device used during endoscopic stone surgery and laser lithotripsy. Stone fragments can be manipulated into the suction cone, providing stone confinement and stabilization for improved targeting and laser energy delivery. Importantly, the suction will clear stone debris to improve visualization and minimize residual fragments after treatment.

Website

https://umich.flintbox.com/technologies/399EA7DC21344FB4896FCC0A2AC95305

Advantages

  • Shortens operative time by containing stones and fragments
  • Increases stone-free rate from suctioning stone fragments and dust
  • Improved procedural safety by reducing heat-related injuries from prolonged lithotripsy

Potential Applications

  • Laser lithotripsy during ureteroscopy
  • Percutaneous nephrolithotomy
  • Miniaturized percutaneous nephrolithotomy

Contact Information

Name: Michelle Larkin

Email: MICHCOTE@umich.edu

Phone: 810-569-2583