Thomas Mueller, MD, on the removal of residual stone fragments

Author(s):

Key Takeaways

The SURE procedure enhances residual kidney stone removal, addressing limitations of traditional ureteroscopy methods.
Traditional techniques often leave residual fragments, leading to potential complications in up to 40% of cases.
SURE provides a more effective and accessible solution for both specialized and general urologists, improving patient outcomes.

“The 1 main assumption that we've been very wrong on although we've had the data for a long period of time, [is that] although we assume that the stone fragments are small enough to pass, oftentimes they don't,” says Thomas Mueller, MD.

In this video, Thomas Mueller, MD, highlights the benefits of the SURE procedure for residual stone removal. Mueller shared a talk titled, “SURE (Steerable Ureteroscopic Renal Evacuation) procedure for the treatment and elimination of kidney stones,” at the 2024 LUGPA Annual Meeting in Chicago, Illinois.

Mueller is a urologist at New Jersey Urology and a program director at Thomas Jefferson University.

Video Transcript:

This is fairly basic stuff from a urologic standpoint, but for kidney stone surgery we have—and let's just keep it to actively intervening, and that being some sort of stone removal procedure. We have ureteroscopy, which is taking a tiny camera, going up that tube, going to a level of stone, then performing laser lithotripsy on those stones. Typically speaking, we would then utilize a basket in order to remove those fragments. I think there are 2 main methodologies as far as urologists are concerned. One is dusting the stone into small fragments and allowing those fragments to be so small that they are able to pass on their own volition. The other technique would be to break up the stone into subsequent pieces, such that you can then use a basket to remove those fragments.

I think that the 1 main assumption that we've been very wrong on although we've had the data for a long period of time, [is that] although we assume that the stone fragments are small enough to pass, oftentimes they don't. And because upwards of 40% of the time there are residual stone fragments, those stone fragments do run the risk of having complications for the patient. I think that a lot of endourologists have been striving to meet that goal, but it is quite an arduous task, and I think that the average urologist may not go through those same types of strides in order to accomplish that task. This is a great technique that can level the playing field, make it easy for the person that does specialize in stones, to the average urologist that you know is going to treat the everyday stone.

This transcript was AI generated and edited by human editors for clarity.