For the first time, the urolithiasis team at Hospital de Clínicas used a modern thulium laser system for lithiasis (fragmentation of kidney stones) through endoscopic surgery on three patients. In the region, HC was the first hospital to use this technology and, in the capital, only a few private hospitals already have the equipment. Its main advantage is the higher-power thulium laser optical fiber, which allows larger and harder stones to be fragmented in less surgical time. The results of the procedures were considered excellent by the team.
According to urologist Wilmar Neto, who was part of the team, the Fiber Dust device was provided for evaluation by the company Handle Equipamentos, based in Ribeirão Preto (SP). HC has equipment that uses another type of laser, holmium. “There are advantages of the thulium laser over the holmium laser, specifically for treating stones, such as reducing surgical time by half compared to other equipment, fewer residual stones and various levels of pulse duration adjustment”, explains Neto.
According to the manufacturer, thulium technology allows, in addition to pulverizing stones, to perform precise and gentle ablation, resection and incision in soft tissues, which requires low to medium power energies, such as in bladder tumors, in addition to strictures. The device is more compact and features technologies that allow for other applications in gastrosurgery, thoracic surgery, kidney surgery and urology, such as prostate surgical procedures. The procedure was monitored by urology and general surgery residents and 6th year students (photo below).
Data from international literature demonstrate that the prevalence of renal stone disease is high, ranging from 2 to 15% worldwide. In the United States, it affects 7 to 12% of the population, and in Europe, 2 to 8%. This pathology occurs most commonly in men aged between 20 and 40 years, but can affect individuals of any age. Stones associated with urinary tract infections are more common in women. Endoscopic surgery using a uretoscope – through which the optical fiber is introduced – is a very efficient procedure to eliminate lithiasis.
