Rapid technological progress poses challenge to stone experts
12 Aug 2015
Rapid developments in technological developments and the wide range of conditions among stone patients pose tough challenges to experts in urolithiasis, requiring many to seek for innovative solutions that enable the delivery of optimal patient care.
“The epidemiology of urolithiasis shows dramatic variability both in incidence and management practices globally. In this rapidly evolving field of endourology, it is crucial that different experts and veterans in the field gather on a common platform to discuss and shape the contemporary management of stone disease,” said Dr. Arvind Ganpule (IN).
Ganpule will be presenting a video to discuss challenging cases in stone disease at the 3rd biennial Meeting of the EAU Section of Urolithiasis (EULIS), which will be held from 10-12 September 2015 in Alicante, Spain.
The meeting gathers urolithiasis specialists from across Europe and neighbouring regions to critically assess current developments and prospects in the diagnosis and treatment of stone disease.
Experts face controversial issues in stone disease particularly patients with frail health, are obese or in difficult paediatric cases.
Ganpule noted there is a wide range of new instruments and diagnostics and the rapid pace by which they are being introduced into actual practice prompts urologists to step up and carefully look into the impact of these devices.
“It would be interesting to discuss the newer innovative minimally invasive armamentarium and novel indications in contemporary endourologic practice. Likewise, the evolving laser systems and their different settings present a new horizon for energy source use in endourology,” added Ganpule, as he noted that the EULIS event precisely aims to offer the opportunity to share best practices and identify those which may later have a significant impact.
In his video presentation titled "Microperc-lower calyx and unfavourable anatomy," Ganpule will discuss the use of microperc in the second video session which will tackle issues involving kidney stones smaller than 3 cm in the lower calyx and those in unfavourable anatomy.
“The microperc involves the use of a 4.85 Fr needle initially described as an “all-seeing” needle. This assembly has the potential to optically confirm optimal renal access. In addition, the stone can be disintegrated with laser energy. All of this is done through the needle itself,” explained Ganpule. “Energy settings are suited and is used for “dusting” rather than for fragmenting.”
He noted that the microperc, in selected patients, offers benefits. “Since tract dilatation being a “single-step” maneuver in this technique, it eliminates the need of multiple exchanges of instruments and dilators, the latter being linked to higher risks of complications such as bleeding and longer fluoroscopy exposure,” said Ganpule.
“During the session we would emphaisize that access could be accomplished under ultrasound or fluoroscopic guidance. I would also stress the importance of adjusting the energy settings (high frequency and low energy) so that preferentially “dusting” is performed which might bring down the incidence of renal colic arising from fragments passing into ureter,” he added.
The video sessions of the EULIS draw enthusiastic participants and previous EULIS meetings show well-attended video sessions due to its emphasis on innovative practice and the insightful exchange between speakers and the participants.
With Prof. Kemal Sarica as EULIS chairman and the local organisation led by Dr. Juan Galan, the EULIS meeting in Alicante follows the 2013 and 2011 EULIS meetings in Copenhagen and London, respectively.