A review of kidney stone ureteroscopy lithotripsy devices

Background: Surgical intervention for kidney stones which utilize ureteroscopy with laser lithotripsy can result in miniscule fragments that are irrigated out. A stone-free outcome does not occur in 42% of procedures, where “clinically insignificant residual fragments” (CIRF) can potentially be pathological. This demonstrates a need for adequate intraoperative CIRF containment methods, which can reduce CIRF pathology and follow-up procedures. This study aims to review popular devices and innovative approaches of existing devices aimed to control CIRF. Methods: A search was conducted on MEDLINE and PubMed for articles related to kidney stone fragments and “anti-retropulsion” devices. A comprehensive list of devices and studies was created with both mechanical and gel-based devices. Results: The following specific types of devices included in this study are baskets, suction devices, gels, and balloon catheters devices. Each device is either a popular device or an innovative one within each device category. A common theme among these devices is that a combination of multiple approaches, such as a balloon and a basket device together, can improve stone free rates. Similarly, using existing devices in novel innovative methods can lead to improvement as well. Conclusions: We find that innovative and effective devices can be accomplished through synthesizing existing knowledge and utilizing novel techniques. Furthermore, these approaches are open to provider modifications to facilitate intraoperative adaptations. As ureteroscopic laser lithotripsy becomes a mainstay in treating kidney stones, innovative and intraoperatively flexible devices can further improve this procedure.