Therapeutic options in stone disease – an overview with special regards to modern minimal invasive tools
Christoph Lang, Schahnaz Alloussi
Urological Department, Städtisches Klinikum Neunkirchen, Academic Teaching Hospital of University of Saarland
Introduction:
A part of stone disease management consists in surgical treatment options since 3000 years. A short overview about development of therapeutic invasiv and minimal invasiv tools over the years is given.
Methods/ Results:
Historic methods and modern accesses were presented with special regard to experiences, results and developments in ESWL/ EPL, Retrograde Intrarenal Surgery (RIRS/ flex.URS) and mini PCNL of a single centre.
Results:
Modern therapeutic tools lead to non-invasive or minimal invasiv options in stone disease management. Open surgery is preserved for special indications and even substituted by laparoscopic interventions. The miniaturisation of instruments and additional working tools like laser devices opens the field for all indications of individualised endoscopic stone disease management.
Conclusions:
- For individualized optimal therapy different tools have to be available
- Variable systems allow individual access
- Procedures have to be easy, fast and successful to perform
- Aims are pain less treatment options with low risk of side effects
- Low cost tools for patient or health system are demanded
- Long life span instrument with minimal maintenance costs are preferred.