Presented by: Gregory Mullen MD
Smith Institute for Urology Northwell Health

Introduction

The goal of surgical treatment of kidney stones is to maximize stone free rate (SFR) while minimizing morbidity. Patients with large volume kidney stone disease and absolute or relative contraindications to percutaneous nephrolithotomy (PCNL) have limited treatment options. We report our experience using a novel steerable ureteroscopic renal evacuation (SURE) device that suctions stone fragments during ureterorenoscopy (URS) with laser lithotripsy.  

Materials

A retrospective review of all cases using SURE in our health system was performed. Patient demographics, stone characteristics, operative demographics, and outcomes were recorded.

Results

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Forty-three cases of SURE were performed on thirty-nine patients. Average preoperative stone volume was 1158 mm3. Twenty-six patients had postoperative imaging performed. Ultrasound (US) was performed on thirteen patients and CT scan was performed on thirteen patients. Of patients who received a CT scan postoperatively, absolute SFR (no stone fragments) was 53.8% and overall SFR (stone fragments up to 4 mm) was 84.6%. There were no intraoperative complications observed. Postoperative sepsis occurred in 5.1% of patients. 

Conclusion

SURE is effective for removal of large volume kidney stones with high SFR and low morbidity.

Funding

None

Lead Authors

Arun Rai, MD
Smith Institute for Urology Northwell Health

Co-Authors

Charan Mohan, MD
Smith Institute for Urology Northwell Health

Luke Griffiths, MD
Smith Institute for Urology Northwell Health

Jared Winoker, MD
Smith Institute for Urology Northwell Health

Tareq Aro, MD
Smith Institute for Urology Northwell Health

David Hoenig, MD
Smith Institute for Urology Northwell Health

Zeph Okeke, MD
Smith Institute for Urology Northwell Health