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Holmium laser treatment of urinary stone disease

Holmium laser has been used to fragment urinary stones during endourological procedures like Cystolithotripsy, Ureterorenoscopy, Percutaneous Nephrolithotripsy (PCNL), and Retrograde Intrarenal Surgery (RIRS using flexible ureteroscope)

The main advantages of Holmium Laser over Pneumatic lithotripter are :

  1. Small size of fibre allows good flow of irrigant fluid through the instrument channel, thus allowing smaller sized ureteroscope / Nephroscope (MINIPERC) to be used.
  2. The chances of proximal migration ( Retropulsion)of stone are reduced.
  3. Chances of perforation of the urothelium which may occur due to counter pressure as a result of mechanical shock waves on the stone during fragmentation by pneumoclast are eliminated.