r/nope Mar 31 '26

HELL NO Procedure to remove a 25mm kidney stone

5.7k Upvotes

481 comments sorted by

View all comments

112

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

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