Lasers in percutaneous renal procedures.
BACKGROUND
Since the invention of lasers in 1960, they have been increasingly used in medicine. In this review paper, the types of lasers used in urology, in addition to their applications to percutaneous renal surgery will be reviewed. Specifically, use of lasers in the percutaneous management of renal stones, upper tract transitional cell carcinoma and stricture will be reviewed.


METHODS
Pubmed was searched for citations since 1966. The following terms were used: "lasers", "calculi", "endopyelotomy", and "transitional cell carcinoma".


RESULTS
Due to its minimal depth of penetration, holmium laser has proven to be safe and efficacious. It is currently the primary energy source for flexible instrumentation, and also has demonstrated efficacy in percutaneous lithotripsy (faster than ultrasonic lithotripsy and safer than electrohydraulic lithotripsy). Holmium laser been used for antegrade endopyelotomy and percutaneous resection of upper tract transitional cell carcinoma.


CONCLUSIONS
Holmium laser is safer than other lasers and has become the gold standard for laser lithotripsy for flexible instrumentation. It has been used successfully in the percutaneous management of renal stones, ureteropelvic junction obstruction, and upper tract transitional cell carcinoma. Holmium laser is an alternative energy source to conventional lithotripters and electrocautery for endopyelotomy and resection of upper tract transitional cell carcinoma.
Cinman
Nadya M
NM
Smith Institute for Urology, North Shore/Long Island Jewish Health System, 450 Lakeville Rd, Suite M-41, New Hyde Park, NY 11040, USA. nadyacinman@yahoo.com
Andonian
Sero
S
Smith
Arthur D
AD
D006801:Humans; D007674:Kidney Diseases / Q000601:surgery* / Q000628:therapy*; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D053844:Lasers, Solid-State; D017602:Lithotripsy, Laser / Q000295:instrumentation / Q000379:methods*