Training in LESS and NOTES

LESS and NOTES are the further step forward the "scarless" surgery recently, which have challenged the main principles of conventional multiport laparoscopy. To develop the surgical skills for these novel techniques, the guideline for training program should be neccesary for its clinical practice to reduce the complications. In this paper, we will summary the challenges of these new technique and introduce our experience of training courses.

Treatment of urinary calculi with ureteroscopy and Swiss lithoclast pneumatic lithotripter: report of 150 cases

PURPOSE

To present our clinic experience with the Swiss Lithoclast pneumatic lithotripter in the endoscopic management of urinary calculi.

PATIENTS AND METHODS

From August 1994 to December 1997, 145 patients with ureteral calculi and 5 patients with urethral calculi were treated with the Swiss Lithoclast.

RESULTS

In the ureteral stone group, ureteroscopic addressing of the stones was successful in 133 patients. In 27 patients, the stones were partially fragmented and remained in situ or were pushed back to the calices. They were subsequently treated successfully with SWL. Stones were fragmented in a single session in 101 cases. Complications associated with the procedure included five perforations and four urinary tract infections. All of the five urethral stone patients were treated successfully with pneumatic lithotripsy. The overall successful fragmentation rate thus was 70.7% (106 of 150) and 88.7% (133 of 150) in combination with adjuvant SWL.

CONCLUSIONS

We have found Swiss Lithoclast pneumatic lithotripsy to be a safe, effective, and economical treatment method for urinary calculi. If combined with other modalities such as SWL, this treatment will be even more effective.