[Stone treatment tomorrow and the day after].
Urological and surgical treatment of urinary stones are highly technological and technology-driven disciplines in present-day surgery. German medical engineering has always been recognized for its technical innovations in endoscopic surgery. Current and future trends are indicative of further miniaturization and automation of surgical instruments and assist systems to facilitate endourological procedures as well as improvements in the quality of results and ergonomics. These technologies include, e. g. 3D-tracking to facilitate access to the pelvicaliceal system for percutaneous nephrolithotomy (PNL) or robotic master-slave systems for endourology. The aim of all future stone treatment should be complete stone removal. This could be achieved by improved stone fragmentation ("micron-sized debris") or complete removal of fragments (e. g. using a "stone glue"). Integration of diagnostic procedures and treatments will constitute a key aspect of future developments in medical engineering. Intelligent laser systems may be capable of distinguishing stones from mucosa and artificial surfaces and may be used for immediate stone analysis during surgery. A simpler and faster availability of metabolic ("metabolomics") and genetic ("genomics") diagnostics will help to facilitate and improve individual metaphylaxis, e. g. in patient self-management. Nanotechnology and microrobots that may be used for endoluminal diagnostics and treatment of the urinary tract are already in development.
Klinik für Urologie, Universitätsklinik Freiburg, Hugstetterstr. 55, 79106, Freiburg, Deutschland.
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Miernik
Klinik für Urologie, Universitätsklinik Freiburg, Hugstetterstr. 55, 79106, Freiburg, Deutschland.
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Hein
Klinik für Urologie, Universitätsklinik Freiburg, Hugstetterstr. 55, 79106, Freiburg, Deutschland.|Max Planck-Institut für Intelligente Systeme, Stuttgart, Deutschland.
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Adams
Klinik und Poliklinik für Endokrinologie und Nephrologie, Sektion Nephrologie, Universitätsklinikum Leipzig, Leipzig, Deutschland.
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Halbritter
Klinik für Urologie, Universitätsklinik Freiburg, Hugstetterstr. 55, 79106, Freiburg, Deutschland. martin.schoenthaler@uniklinik-freiburg.de.
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Schoenthaler
D003131:Combined Modality Therapy / Q000639:trends; D005544:Forecasting; D006801:Humans; D008096:Lithotripsy / Q000639:trends*; D019060:Minimally Invasive Surgical Procedures / Q000639:trends; D009403:Nephrostomy, Percutaneous / Q000639:trends*; D018802:Patient-Centered Care / Q000639:trends*; D025321:Surgery, Computer-Assisted / Q000639:trends*; D016896:Treatment Outcome; D018666:Ureteroscopy / Q000639:trends*; D052878:Urolithiasis / Q000175:diagnosis / Q000628:therapy*; D014572:Urology / Q000639:trends
Endourology; Future technologies; Nephrolithotomy, percutaneous; Surgical treatment of urinary stones; Ureteroscopy