Clinical Impact of the Institution of Moses Technology on Efficiency During Retrograde Ureteroscopy for Stone Disease: Single Center Experience.

To evaluate the clinical benefits of Moses technology compared to the regular mode with the Lumenis® Pulse™ P120H holmium laser during ureteroscopy for stone disease.

An IRB approved database of patients with urolithiasis was analyzed for ureteroscopies from 1/2020 - 12/2020 at an outpatient surgery center. Patients who underwent ureteroscopy with the Lumenis® Pulse™ P120H holmium laser system with the Moses or regular mode were included. Patient characteristics and stone parameters were collected. Operative room parameters were compared including procedural time, fragmentation/dusting time, lasing time and total energy used. Complication rates and stone free rates were also analyzed. Univariate analysis and MANCOVA controlling for cumulative stone size were performed. Patients with staged procedures were excluded.

Of 197 surgical cases, 176 met inclusion criteria. Moses was utilized in 110 cases and regular mode in 66. There was no difference in cumulative stone size between Moses and regular modes (11.8±7.9 vs 11.6±9.2 mm, p=0.901). Procedural time (43.5±32.1 vs 39.8±24.6 min, p=0.436), fragmentation/dusting time (20.5±25.3 vs 17.1±16.1 min, p=0.430), lasing time (7.5±11.1 vs 6.7±7.9 min, p=0.570) and total energy used (5.1±6.7 vs 3.8±4.8 kJ, p=0.093) were also similar. Complications (6.4% vs 6.1%, p=0.936) and stone free rates (61.6% vs 73.5%, p=0.163) did not differ.

At our institution, Moses technology did not significantly change procedural time, fragmentation/dusting time, lasing time or total energy used. Moreover, there were no differences in complications or stone free rates. There may be technical benefits to Moses technology not captured in this analysis.

Journal of endourology. 2021 Jul 08 [Epub ahead of print]

Margaret Knoedler, Shuang Li, Sara L Best, Sean P Hedican, Kristina L Penniston, Stephen Y Nakada

University of Wisconsin, Department of Urology, 1685 Highland Ave, Madison, Wisconsin, United States, 53705; ., University of Wisconsin, Urology, Madison, United States; ., University of Wisconsin School of Medicine and Public Health, Urology, 1685 Highland Ave, MFCB-3229, Madison, Wisconsin, United States, 53705., University of Wisconsin School of Medicine and Public Health, Urology, Madison, Wisconsin, United States; ., University of Wisconsin School of Medicine and Public Health, Urology, 1685 Highland Avenue, 3258 MFCB, Madison, Wisconsin, United States, 53705-2281; ., University of Wisconsin-Madison School of Medicine and Public Health, 5232, Madison, Wisconsin, United States; .