Holmium: YAG percutaneous nephrolithotomy: The laser incident angle matters

Joel M H Teichman, Ramesh D. Rao, Randolph D. Glickman, J. Mansel Harris

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Purpose: Laser physics dictate that maximal radiant exposure occurs when the laser strikes the target at a normal incidence. Since the renal collecting system often limits nephroscope movements during percutaneous nephrolithotomy, the laser-calculus incidence angle may vary. We have observed during holmium:YAG percutaneous nephrolithotomy that the side firing fiber more easily approaches a normal incidence compared to the end firing fiber. We test the hypothesis that holmium:YAG percutaneous nephrolithotomy is faster with a side firing fiber compared to an end firing fiber. Materials and Methods: Consecutive holmium:YAG percutaneous nephrolithotomy cases were studied retrospectively. The calculus size and composition, surgical time, fragmentation speed (size/time) and stone-free rates were compared between 11 patients treated with end and 8 treated with side firing fibers. Results: When the end and side firing groups were compared, calculus sizes (mean plus or minus standard deviation) were 22 ± 13 versus 48 ± 17 mm. (p = 0.004), calcium oxalate monohydrate incidence was 55 versus 75% (p = 0.3), surgical times were 168 ± 87 versus 124 ± 51 minutes, computed fragmentation speeds were 0.15 ± 0.09 versus 0.43 ± 0.15 mm. per minute (p = 0.0009) and stone- free rates were 73 versus 88% (p = 0.4), respectively. Conclusions: The side firing fiber is faster than the end firing fiber for holmium:YAG percutaneous nephrolithotomy. These results are consistent with principles of laser physics.

Original languageEnglish (US)
Pages (from-to)690-694
Number of pages5
JournalJournal of Urology
Volume159
Issue number3
DOIs
StatePublished - Mar 1998

Fingerprint

Holmium
Percutaneous Nephrostomy
Lasers
Calculi
Incidence
Physics
Operative Time
Calcium Oxalate
Kidney

Keywords

  • Holmium
  • Lasers
  • Lithotripsy

ASJC Scopus subject areas

  • Urology

Cite this

Holmium : YAG percutaneous nephrolithotomy: The laser incident angle matters. / Teichman, Joel M H; Rao, Ramesh D.; Glickman, Randolph D.; Harris, J. Mansel.

In: Journal of Urology, Vol. 159, No. 3, 03.1998, p. 690-694.

Research output: Contribution to journalArticle

Teichman, Joel M H ; Rao, Ramesh D. ; Glickman, Randolph D. ; Harris, J. Mansel. / Holmium : YAG percutaneous nephrolithotomy: The laser incident angle matters. In: Journal of Urology. 1998 ; Vol. 159, No. 3. pp. 690-694.
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