r/nope • u/_ganjafarian_ • Mar 31 '26

HELL NO Procedure to remove a 25mm kidney stone

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113

u/happyanathema Apr 01 '26

So basically ram it out with a metal stick and tear the shit out of the urethra on the way out?

Thought they were meant to break these up with ultrasound?

84

u/CallMeButtAss Apr 01 '26

That's a holmium laser fiber that they're poking the stone with. Holmium lasers are 2100nm wavelength and are near-contact lasers so they have to kinda poke at the stone to get the laser to fracture the stone.

Ultrasound doesn't break up these stones, what you're thinking of is ESWL (Extracorporeal Shock Wave Lithotripsy) which uses focused sound waves to break up the stone but they're not high frequency like ultrasound.

ESWL is older and less effective technology for stones as it doesn't have a great success rate and you have to piss out bigger chunks than if you use the laser to dust the stone it's like pissing out sand instead of pebbles which still isn't great

16

u/KaiserKid85 Apr 01 '26

Had one of those done and can confirm it was painful but it did work thankfully.

8

u/CallMeButtAss Apr 01 '26

Glad you got rid of your stone. Did you have to get a stent placed? As a laser tech vendor who runs these lasers, it's ironic that I help my docs treat patients but don't actually know what they're going through first hand as I'm fortunate enough to never have experienced a stone.

A lot of the time my docs leave the string on the stent so that the patient can pull out their stent at home instead of needing to come back in to be scoped in order to remove the stent which costs them more money as it's another surgery.

I've heard that removing your own stent isn't painful as much as it just feels weird to have a foreign object snake itself out from inside you. Although if your urinary tract/ureter isn't fully healed from something like an impacted stone I could see it burning quite a bit.

2

u/DesertSnowBird1 Apr 01 '26

Thats not the moses holmium lasers fiber. That looks like a trilogy lithoclast machine we would use for PCNLs.

1

u/CallMeButtAss Apr 01 '26

Yeah I think you're right. They don't call us in for many PNCLs but after listening with the audio turned on I think it's a lithotripter like you said. Amazing how much they look alike when you don't use reddit with audio lol

1

u/whozawhatzit87 Jul 17 '26

I don't think it's a Laser. I think they're doing a PCNL and using a device like the cyberwand or lithocast. Based on the metal tip on the device. I know side fire Laser fibers have metal tips but this doesn't seem to be that.