The clinical outcomes of laser with suction device in mini-percutaneous nephrolithotomy

Objective To evaluate the safety, efficacy and feasibility of laser with suction device in mini-percutaneous nephrolithotomy (PCNL). Methods A retrospective study was conducted including 200 patients who underwent mini-PCNL for renal stones. All patients underwent PCNL using Electro-Medical Systems ([EMS] S.A., Nyon, Switzerland) laser. In addition to the laser in 100 patients, a suction device was used (laser with suction [LWS]). In the other 100, suction device was not used (laser with no additional suction device, [LOS]). Mini-PCNL was performed using standard technique and Karl Storz MIP-M system was used. Primary end point was stone clearance. Results Both the group were comparable in terms of demographic data. Mean stone size was 15.24 ± 5.90 mm and 16.16 ± 5.53 mm in LWS and LOS respectively. Mean Hounsfield unit (HU) of stone was 1285.64 and 1206.79 in LWS and LOS respectively. Operative time was less in LWS group (56.89 ± 19.65min) as compared to LOS (62.01 ± 28.81 min). At one-month follow-up, radiological complete clearance was 96% in LWS and 92% in LOS. On subgroup analysis of stones larger than 18 mm, the clearance rate was in favour of LWS (85.7% vs. 100%) and also the need for nephrostomy placement was less in LWS group. Conclusions Laser with suction device is safe and efficacious when used with mini-PCNL. For stones greater than 18 mm, it has a better stone free rate as compared to using no suction.