Recent advances in lithotripsy

Written by: Dr. Ildefonso Santos García-Vaquero
Published: | Updated: 16/11/2018
Edited by: Top Doctors®

The Holmium Laser is an innovative technology and extremely efficient lithotripsy to treat all kinds of calculi (stones), whatever its composition, so that is now considered the gold standard of laser lithotripsy. Its main features are:

  • Optimal control specialist in Urology during treatment: the laser induces a propulsion or minimal movement on the calculation.
  • Fibers different caliber: be small caliber and highly flexible, so can be used to treat any endoscope and calculations even in the ureter.

Thus, almost any calculation located in any area of ​​the renal collecting system can be treated with Holmium Laser efficiently.


Holmium Laser lithotripsy: Understanding

This technique is basically carried out by placing the fiber on the calculation and then activating the laser. It is important that the tip of the fiber is maintained slightly in contact with the stone throughout the procedure, without losing direct visualization.

Unlike other lasers, the holmium laser does not depend on the shock waves, but the thermal effects, since the emission of shock waves through this technology is too weak to overcome the compression forces and sensory most calculations, especially ureteral and intrarenal.

Thus, the treatment involves both vaporize the surface of the stone as the water inside surface by heating the small laser pulses. Thanks to this procedure, an ablative effect on small areas of the stone occurs, weakening the tensorial forces inside.

Then, the laser produces small shockwaves to finish fragmentas weakened the calculation was previously. This effect has been called "Drilling Effect" (effect drilling) by some researchers as the vaporization makes the calculation in such small pieces that is considered a thin layer of stone dust.


Types of Holmium Laser Lithotripsy

Within this process, there are three different techniques:

  • Multiple drilling is to penetrate the interior of the calculation using the tip of the fiber and emitting a thin layer of stone dust to generate several holes on the surface.
  • Ablating a surface Cavity work it is distinguished by a greater distance from the stone in order to get a larger cavity in the calculation. Thanks to this technique, mainly vaporizes the calculation so that it can break up easily, without creating too many pieces.
  • Direct Fragmentation is the most commonly used technique, especially when the stones are small or are located in areas with little freedom of movement. Is calculated directly fragmentas into small pieces.
*Translated with Google translator. We apologize for any imperfection

By Dr. Ildefonso Santos García-Vaquero

Renowned specialist in Urology, Dr. Santos García-Vaquero has a degree in Medicine and Surgery from the Complutense University of Madrid in 1975, she specializes MIR and Doctor of Medicine and Surgery cum laude. Endourological Section Chief at the Regional Hospital Carlos Haya in Malaga. Throughout his career he has combined his clinical work with management courses related to various techniques such as urology laparoscopy course in the National Congress of Urology in 2005. Currently on leave from the Department of Urology at the Hospital Carlos Haya . Member of the leading scientific societies in the world such as the European American Association of Urology and Spanish. His extensive resume also supports 125 in contributions it has made in terms of communications, articles and lectures nationally and reported internationally.

*Translated with Google translator. We apologize for any imperfection

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