Holmium laser has been established asthe gold-standard for the ureteroscopic management of urinary stone disease. However the role of laser inpercutaneous nephrolithotomy (PCNL) varies, as multiple energy sources and lithotripters are available. Currently, lasers are becoming more relevant with the development of several miniaturized PCNL techniques. The purpose of this article is to review the role of laser in percutaneous renal surgery, and whether or not it is the best option for this approach. Discussion points include: the history and background of lasers in urologic surgery, PCNL and its outcomes in the literature, the positives and negatives of lasers versus other lithotripters in several different PCNL techniques, emerging laser technology such as thulium fiber laser, the use of lasers in establishing percutaneous renal access, and laser's role in non-stone percutaneous renal surgery.
El láser holmium está establecido como gold-standard en el manejo de la litiasis con ureteroscopio. El papel del láser en la nefrolitotomía percutánea varía ya que existen varios tipos de láser. El objetivo de este artículo es revisar el papel del láser en la cirugía percutánea renal para determinar si es una buena opción terapéutica. Discutiremos la historia del láser en urología, nefrolitotomía percutánea y sus resultados en la literatura, los pros y contras de los láseres vs otros litotriptores como el tulio, el uso del láser para establecer el acceso percutáneo; el papel del láser en la cirugía percutánea no-litiásica.
Archivos espanoles de urologia. 2020 Oct [Epub]
Henry C Wright, Zachary Sherman, Manoj Monga, Smita De
Department of Urology. Glickman Urological and Kidney Institute. Cleveland Clinic. Cleveland. OH., University of Tennessee College of Medicine. University of Tennessee Health Science Center., Department of Urology. Glickman Urological and Kidney Institute. Cleveland Clinic. Cleveland. OH. Department of Urology. UCSD. San Diego. CA.