Giant ureteral stoneClearPetra ureteral access sheathInjection of salineTamura method

The ClearPetra (Well Lead Medical, Guangzhou, China) has recently entered the market, enabling continuous stone fragmentation and removal while maintaining a continuous perfusion field of view. The efficacy and safety of the ClearPetra renal access sheath (RAS) in percutaneous nephrolithotomy (PCNL) and endoscopic combined intrarenal surgery (ECIRS) have been reported. However, no reports have described the use of the ClearPetra ureteral access sheath (UAS). Here, we report a case of successful ureteroscopic lithotripsy (URSL) for a giant ureteral stone by effectively utilizing the ClearPetra UAS.

We encountered a case in which URSL was safely and efficiently performed for a giant ureteral stone using the ClearPetra UAS. The ClearPetra UAS offers an important tool for treating giant ureteral stones, and what made it possible was the injection of saline through a dual-lumen ureteral access catheter inserted from the nephrostomy side. Once clinicians learn about this new method, it will likely be considered obvious in retrospect.

Tomoya Nao, Ryohei Iga, Rie Yoshimura, Yoshitaka Kurano, Shinkuro Yamamoto, Kenji Tamura

N/A

Retrograde intrarenal surgery (RIRS) is a well-established treatment option for renal calculi. Stone dusting has drastically improved with the advent of high-power LASERs, but the challenge remains in clearing the fine dust and fragments which may become niduses for future stone recurrence. The aim of this article is to demonstrate the use of the Flexible And Navigable ureteric access Sheath (FANS), a novel invention which improves the aspiration of stone dust and fragments, and assess its safety and outcomes.

FANS improves single-session SFR and reduces the need for a ureteric stent or catheter. It is safe with minimal complications, reduces the need for ancillary treatment and post-operative follow-up, therefore resulting in cost savings for the hospital and patient.

Vineet Gauhar, Chloe Shu-Hui Ong, Olivier Traxer, Ben Hall Chew, Nariman Gadzhiev, Jeremy Yuen-Chun Teoh, Saeed Bin Hamri, Chin Tiong Heng, Daniele Castellani, Bhaskar Kumar Somani, Deepak Ragoori

fever; staghorn stones; stone-free rate; vacuum-assisted mini-endoscopic combined intrarenal surgery.

This retrospective cohort study aimed to evaluate the clinical outcomes of vacuum-assisted mini-endoscopic combined intrarenal surgery (vmECIRS) for staghorn stones.

These findings suggest that vmECIRS is safe and effective for treatment of staghorn stones. Although current guidelines suggest that percutaneous nephrolithotomy is the gold standard surgical technique for staghorn stones, vmECIRS could also be a treatment strategy. The Clinical Trial Registration number (ID: 2022-05-17-1).

Tominaga K, Inoue T, Yamamichi F, Fujita M, Fujisawa M. Impact of Vacuum-Assisted Mini-Endoscopic Combined Intrarenal Surgery for Staghorn Stones: Analysis of Perioperative Factors of Postoperative Fever and Stone-Free Status. J Endourol. 2023 Apr;37(4):400-406. doi: 10.1089/end.2022.0579. Epub 2023 Feb 27. PMID: 36641643.

bladder calculi; cystolitholapaxy; super-mini percutaneous cystolitholapaxy; thulium fiber laser.

This single-center experience describes the indications, novel technique, and outcomes of performing 14F super-mini percutaneous cystolitholapaxy (14F-SMPCCL).

The novel technique of 14F-SMPCCL is safe and feasible for treating large burdens of bladder stones with a conglomerate size of ~ 2.5 to 5 cm. Active suction allows for efficient removal of stone fragments.

Fonseka T, Melchionna A, De Luyk N, Arumuham V, Noah AO, Choong S. 14F Super-Mini Percutaneous Cystolitholapaxy: A Novel Technique in the Treatment of Bladder Stones. J Endourol. 2023 Apr;37(4):422-427. doi: 10.1089/end.2022.0697. Epub 2023 Feb 3. PMID: 36633922.

super-mini percutaneous nephrolithotomy, kidney stones, complications.

To present a novel miniature endoscopic system designed to improve the safety and efficacy of percutaneous nephrolithotomy, named the ‘super-mini percutaneous nephrolithotomy’ (SMP).

SMP is a safe and effective treatment for renal stones of <2.5 cm. SMP may be particularly suitable for patients with lower pole stones and stones that ae not amenable to retrograde intrarenal surgery.

Zeng G, Wan S, Zhao Z, Zhu J, Tuerxun A, Song C, Zhong L, Liu M, Xu K, Li H, Jiang Z, Khadgi S, Pal SK, Liu J, Zhang G, Liu Y, Wu W, Chen W, Sarica K. Super-mini percutaneous nephrolithotomy (SMP): a new concept in technique and instrumentation. BJU Int. 2016 Apr;117(4):655-61. doi: 10.1111/bju.13242. Epub 2015 Aug 22. PMID: 26220396.