Laser Lithotripsy

Laser Lithotripsy is a procedure that uses Laser to break up stones in the kidney, bladder, or the ureter.

Kidney stones may develop due to the crystallisation of certain components in urine. Some stones are small enough to pass out with the flow of urine, while large stones can lodge in some part of the urinary tract, blocking the passage of urine. This can lead to severe abdominal, lower back or groin pain, infection and kidney damage. Large kidney stones may be treated by breaking the stones into smaller fragments so that they can easily pass out through the urine. This may be accomplished with the help of ureteroscope and laser.

Procedure

A thin lighted tube equipped with a camera, called a ureteroscope, is passed through the urethra and bladder and into the ureter and kidney.

The lower half of the kidney can be accessed with a rigid ureteroscope and the kidney can be accessed with a flexible ureteroscope.

Once the stone is located with the ureteroscope, instruments can be passed through the scope to treat the stone. Very thin laser fibres, diameter ranging from 0.2 to 0.4mm, are used to treat the stone and break it down into very fine fragments of less than 1 mm. These fragments are then flushed out. This is only used for small stones to avoid damage to the ureter. Since the stone is directly visualised during stone treatment, the stone fragmentation and clearance rate is very high.

Ureteroscopy is performed through the urethra and no incision is required. Recovery from surgery is quick, and this operation is usually performed as day surgery. A general anaesthetic is required. The stone can be treated in one session most of the times, sometimes, if the ureter is swollen or if the stone is large, more than one session may be required to completely remove the stone. A stent is usually left in the ureter for one week following ureteroscopy to facilitate drainage of urine and passage of fragments. Without a stent, swelling of the ureter after ureteroscopy can cause obstruction and pain.

Most patients will notice some pain and blood in the urine after the operation for a few days. Stent symptoms will persist until the stents are removed. Most patients can expect to return to full activity one week after surgery.