Is the ablation stone efficacy and efficiency better with a flexible and navigable suction ureteric access sheath?
Materials and methods: A retrospective study of 96 patients who underwent RIRS using thulium fiber laser was performed. We divided the patients into Group 1: FANS and Group 2: c-UAS. We assessed the lithotripsy efficiency (mm3/Joules), ablation efficacy (mm3/min), and laser energy consumption (Joules/mm3). The stone-free rate (SFR) was defined as the absence of stone fragments in a non-contrast abdominal computed tomography 4-weeks after the procedure.
Results: Both groups presented comparable stone volume (mm3) and stone density. RIRS with FANS presented a significantly lower surgical time and laser energy consumption (10.9 vs. 12.1 Joules/mm3, p < 0.001). In addition, FANS presented higher ablation efficiency (0.22 vs. 0.09 mm3/Joules, p < 0.001) and ablation efficacy (26.1 vs. 19.9 mm3/min, p < 0.001). SFR was significantly higher in the FANS group (93.7% vs. 75%, p < 0.001).
Conclusion: Compared to c-UAS, RIRS with FANS was associated with decreased total operative time and laser energy consumption and presented a significantly higher ablation efficacy and efficiency. Additionally, SFR was significantly higher in the FANS group.
Luis Rico, Victoria Diaz-Zorita, Leandro Blas, Lorena Banda Ramos, Pablo Sabeh & Pablo Contreras
Department of Urology, Hospital Aleman, Buenos Aires, Argentina
Source: Rico, L., Diaz-Zorita, V., Blas, L. et al. Is the ablation stone efficacy and efficiency better with a flexible and navigable suction ureteric access sheath?. World J Urol 43, 219 (2025). https://doi.org/10.1007/s00345-025-05610-8.