Holmium laser percutaneous nephrolithotomy using a unique suction device

Background and Purpose: Most percutaneous nephrolithotomies are performed with electrohydraulic, ballistic, or ultrasonic lithotripsy, with holmium laser use reserved for ureteroscopy or ureterorenoscopy. We evaluated the feasibility of holmium laser use in percutaneous nephrolithotomy with the assistance of a unique suction device. Patients and Methods: The charts of 71 consecutive patients undergoing 90 percutaneous procedures were reviewed. A unique suction device and the holmium laser were used in nearly half the patients. The average stone burden was 3.25 cm. Use of holmium laser, energy settings, stone burden, operative time, complications, and stone-free rate were evaluated. Results: The average operative time was 167 minutes with a complication rate of 14%. A stone-free rate of 83% was achieved with the laser. Conclusions: With the assistance of a unique suction device, the holmium laser can, in the appropriate situation, be an efficient and successful lithotrite with percutaneous nephrolithotomy.