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At least 73 records · Page 4Linked to original sources
PubMed1992

Pulsed dye laser lithotripsy--the Toa Payoh Hospital experience.

We report our experience with pulsed dye laser lithotripsy in the treatment of 100 ureteric stones in 95 patients over a 14-month period from July 1989 to September 1990. The overall rate of successful stone fragmentation was 97%. There was a low incidence of minor complications--mild haematuria, ureteric colic and urinary tract infection; ureteric perforation occurred in only 3 patients, all of whom were successfully treated conservatively. Pulsed dye laser lithotripsy is a safe and effective mode of treatment for ureteric stones. Current indications for laser fragmentation of stones are ureteric stones, impacted pelviureteric junction stones and Steinstrasse.

Adult↗
PubMed1998

Laser lithotripsy of difficult bile duct stones: results in 60 patients using a rhodamine 6G dye laser with optical stone tissue detection system.

INTRODUCTION: Laser lithotripsy of bile duct stones has become a widely accepted endoscopic treatment modality for giant, impacted, or very hard stones. The procedure is usually carried out under direct endoscopic control in view of the potential risk of bile duct injuries in "blind" laser application. AIMS: To investigate the use of a rhodamine 6G laser lithotriptor with an integrated optical stone tissue detection system (oSTDS). METHODS: From 1 September 1991 to 7 March 1997, 60 patients with giant or impacted common bile duct stones refractory to endoscopic papillotomy stone extraction, and mechanical lithotripsy were treated via the endoscopic retrograde route using a rhodamine 6G dye laser (595 nm, 2.5 micros, 80-150 mJ pp, Lithognost Telemit/Baasel Corp., Germany) with integrated oSTDS. In case of tissue contact oSTDS cuts off the laser pulse after 190 ns (transmission of 5-8% of the total pulse energy). 47 patients (78.3%) were subjected to x ray targeting (oSTDS) alone, five (8.3%) to choledochoscope targeting alone, and eight (13.3%) to both techniques. RESULTS: At the end of treatment 52 (87%) patients were completely stone-free. The only major complications included transient haemobilia, cholangitis, and pancreatitis in five patients. All five were successfully treated by conservative methods. CONCLUSIONS: Laser lithotripsy using the described rhodamine 6G dye laser with oSTDS seems to be safe and effective and allows "blind" fragmentation of difficult common bile duct stones under radiological control only.

Adult↗
PubMed1991

Transhepatic laser lithotripsy of choledocholithiasis: initial clinical experience.

Three patients with symptomatic intra- and extrahepatic choledocholithiasis who were not good candidates for retrograde endoscopy, surgery, or extracorporeal shock wave lithotripsy (ESWL) were treated successfully with endoscopically guided tunable dye laser lithotripsy via a 12-F transhepatic sheath. There were no complications secondary to the use of the laser. On the basis of this initial experience, transhepatic laser lithotripsy is a technically feasible and safe alternative when choledocholithiasis cannot be managed with retrograde endoscopy, ESWL, or surgery. Its role in the management of choledocholithiasis relative to other transhepatic techniques remains to be determined.

Adult↗
PubMed1991

Endoscopic laser lithotripsy: safe, effective therapy for ureteral calculi.

At our lithotripsy department more than 400 patients with renal or ureteral calculi have been treated with a pulse-dye laser for stone disease. We review our experience during an 11-month period when a total of 223 patients was treated. Of these patients 204 whose ureteral calculi were treated by laser lithotripsy are available for followup. The data in this series demonstrate that a miniaturized ureteroscopic system is of paramount importance in laser lithotripsy, allowing access into the ureter without dilation in the majority of patients (165 of 204). Lack of dilation is associated with a decrease in pain and postoperative hospitalization. Satisfactory stone fragmentation was accomplished in 198 of 204 procedures in this series with use of the laser alone. A low complication rate was observed. Endoscopic laser lithotripsy is a safe, reliable and cost-effective method of therapy for ureteral calculi in a community hospital setting.

Endoscopes↗
PubMed1993

[Laser lithotripsy in the treatment of bile duct calculi].

Currently more than 90% of all common bile duct stones can be removed non-surgically by means of endoscopic sphincterotomy, stone extraction and mechanical lithotripsy. For impacted, very large or very hard concrements intracorporeal shock wave lithotripsy by means of pulsed lasers represents a clinically newly established treatment procedure. Most clinical experience exists using the pulsed dye laser applied cholangioscopically via the endoscopic-retrograde or percutaneous-transhepatic route. The development of commercially available fine-caliber-endoscopes allows a relatively easy access to the stone compared to conventional mother-baby-scope-systems. A new stone-tissue-detection-system (STDS) in combination with a rhodamine-6G dye laser is promising for "blind" laser-lithotripsy using standard ERCP- or balloon catheters or a special lithotriptor basket. After successful conclusion of our in vitro and animal studies concerning the STD system we report on 18 patients with giant common bile duct stones using STDS in combination with a Rhodamin-6G dye laser.

Bile Ducts↗
PubMedDate not supplied

Endoscopic pulsed dye laser lithotripsy of gallbladder calculi in vivo.

We have evaluated the efficacy and safety of pulsed dye laser lithotripsy of gallbladder calculi using a percutaneous endoscopic technique in a porcine model. Fragmentation was readily achieved in vivo. Using a combination of laser lithotripsy and saline lavage, complete removal of all stone debris was feasible through a 24 F tract (N = 3). However, the degree of fragmentation required rendered removal through a smaller tract inefficient, a mean 53% of stone mass being retrievable through a 16 F tract (N = 11). Repeated laser activation at 1 mm from the gallbladder mucosa produced minimal injury, regardless of pulse energy. When the laser fiber was pressed against the mucosa, perforation of the gallbladder was possible at therapeutic pulse energy, but this did not lead to clinical sequelae. We conclude that the pulsed dye laser is a safe and effective means of fragmenting gallbladder calculi in vivo.

Animals↗
PubMed2001

Failure of holmium:yttrium-aluminum-garnet laser lithotripsy in two horses with calculi in the urinary bladder.

Holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripsy was attempted in a mare and a gelding with calculi in the urinary bladder. The procedure was unsuccessful in producing adequate fragmentation of the calculi. In the gelding, pulsed dye laser lithotripsy was subsequently used to fragment the urolith. Manual removal of the urolith via the urethra was performed in the mare.

Animals↗
PubMed2005

In-situ holmium laser lithotripsy for impacted urethral calculi.

BACKGROUND AND PURPOSE: Urethral calculi usually present as acute retention of urine. The issues in this rare clinical problem are its emergency management scenario, small urethral caliber, and long-term risk of stricture formation. In this retrospective study, the positive experience with the safety and efficacy of holmiumlaser lithotripsy for ureteral calculi was applied to the management of urethral calculi, and the initial results were analyzed. PATIENTS AND METHODS: From October 1999 to June 2003, 42 patients presented with symptomatic urethral calculi. Under anesthesia, an attempt was made to push the calculus back in the bladder using lidocaine jelly. In 18 patients in whom this attempt failed, in-situ intracorporeal holmium lasertripsy was performed under cystourethroscopic guidance. RESULTS: All the patients were rendered stone free after a single endoscopic procedure. There were no intraoperative or postoperative complications. At a mean follow-up of 22.28 months (range 5-35 months), 17 of the patients having lasertripsy were asymptomatic with no evidence of development of urethral stricture. CONCLUSION: Intracorporeal intraurethral holmium lasertripsy is a feasible, safe, and effective minimally invasive alternative for the treatment of impacted male urethral calculi.

Adolescent↗