Urology treats urinary tract diseases in all genders and male reproductive issues, covering the kidneys, bladder, prostate, urethra, from infections to complex cancers.
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Endoscopic technologies have transformed urological treatments, moving from traditional open surgeries to less invasive, more precise methods. At Liv Hospital’s Urology Department, Laser Lithotripsy is the main treatment for urinary stones. This technique uses advanced optics and laser technology to treat stones anywhere in the urinary tract while keeping the body’s structure intact. Laser Lithotripsy is part of Endourology, which focuses on procedures done through natural body openings, like the urethra, so there are no external cuts.
This procedure works well because of the advanced laser technology it uses. The word lithotripsy comes from Greek, with ‘lithos’ meaning stone and ‘tripsis’ meaning to break down. In laser therapy, stones are broken apart using heat and mechanical energy. Most top centers use the Holmium Yttrium Aluminum Garnet (Ho: YAG) laser for this purpose.
Laser Lithotripsy is the therapeutic modality, but it relies on specific delivery methods depending on the anatomical location of the calculus.
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Laser lithotripsy is an endoscopic surgical procedure where a camera is inserted into the body to visualize the stone directly and destroy it with a laser fiber. It is exact and practical for rocks of all hardness. Shock wave lithotripsy ESWL is a non-invasive procedure that uses sound waves generated outside the body to break the stone. ESWL is less invasive but may require multiple sessions and is often less effective for very hard or large rocks.
The Holmium laser used in lithotripsy has a very shallow depth of penetration, typically less than 0.5 mm. Because the procedure is performed in a fluid environment, thermal energy dissipates rapidly. While the laser is powerful enough to vaporize stone, the risk of thermal injury to delicate ureteral or renal tissue is minimal when performed by experienced hands.
Retrograde refers to the direction of approach, in which urine flows against its natural flow. Since urine flows from the kidney down to the bladder, the surgeon inserts the instruments starting at the urethra, moving up into the bladder, and then ascending the ureter to reach the kidney. This approach utilizes the natural urinary pathways, eliminating the need to cut through skin or muscle.
Yes, one of the defining advantages of the Holmium laser is its versatility. It is effective against all types of urinary stones, regardless of their chemical makeup. This includes calcium oxalate, calcium phosphate, uric acid, struvite, and even the notoriously hard cystine stones associated with genetic disorders. The laser energy destabilizes the crystal lattice of any stone type.
Laser lithotripsy is classified as a minimally invasive endoscopic procedure rather than major open surgery. There are no external incisions, and patients typically recover much faster. However, it is performed under general anesthesia to ensure the patient remains perfectly still, as precision is required to operate safely within the narrow confines of the urinary tract.
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