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Innovations in the Surgical Management of Nephrolithiasis

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Urologic Principles and Practice

Part of the book series: Springer Specialist Surgery Series ((SPECIALIST))

Abstract

Innovations in technology and surgical approach have rapidly changed the landscape of endourology, which has been a discipline particularly adept at advancing the status quo. Within the span of 50 years, urologists have gone from treating stones with open surgery to utilizing digital flexible ureteroscopes and advanced percutaneous access techniques. This chapter addresses the latest advances and trends in ureteroscopy and percutaneous nephrolithotomy (PCNL) with the goal of providing the reader with knowledge for application in current practice and expectations for future advances. Within ureteroscopy, the Moses Ho:YAG laser has emerged as a new standard while the thulium fiber has shown early promise. Modern single-use ureteroscopes have demonstrated similar operative characteristics to reusable ureteroscopes and give the urologist a valuable tool worth considering, especially for providers with low ureteroscopy volume or cases with anticipated high-wear. In PCNL, there has been a renewed interest in alternative patient positioning to the classic prone position. Modified supine positioning allows for endoscopic combined intrarenal surgery (ECIRS) which provides unique advantages at the expense of increased cost. In addition to increased use of ultrasound, percutaneous access technique is currently undergoing many exciting developments utilizing real-time 3D tracking software. Lastly, miniaturized PCNL systems are becoming increasingly popular with some results showing reduced morbidity and similar efficacy compared to conventional PCNL; however, well designed trials are lacking and their specific use-case scenarios remain to be well defined.

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Authors and Affiliations

  1. Department of Urology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA

    Christopher Haas, Marla Wardenburg & Ojas Shah

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  2. Marla Wardenburg
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Correspondence to Ojas Shah .

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Editors and Affiliations

  1. Sheffield Teaching Hospitals NHS Foundation, Sheffield, UK

    Christopher R. Chapple

  2. Department of Urology, University of Virginia, Charlottesville, VA, USA

    William D. Steers

  3. Department of Urologic Surgery, University of California, Davis, Sacramento, CA, USA

    Christopher P. Evans

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Haas, C., Wardenburg, M., Shah, O. (2020). Innovations in the Surgical Management of Nephrolithiasis. In: Chapple, C., Steers, W., Evans, C. (eds) Urologic Principles and Practice. Springer Specialist Surgery Series. Springer, Cham. https://doi.org/10.1007/978-3-030-28599-9_24

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