Abstract
Introduction:
We present our initial experience using the Moses 2.0 system for flexible-ureteroscopy (f-URS) high-frequency renal stone dusting, including a step-by-step video guide of our clinical principles for dusting technique.
Materials and Methods:
Twelve consecutive patients undergoing f-URS with Moses 2.0 (Lumenis) for a single renal stone by a single surgeon at an ambulatory center were reviewed. Stone-free rates (SFRs) and Clavien grade complications were assessed. Operative steps with illustrative examples are provided in an accompanying video.
Results:
Mean (range) stone size and lithotripsy time were 10.4 (5.3–17.2) mm and 15.0 (5–26) minutes, respectively. Complete SFR and <2 mm residual fragments were 82% and 18%, respectively. One patient had a Clavien Grade 1 complication. Operative steps reviewed include instrumentation, stone control, laser settings, and stent omission criteria. The preferred laser settings for renal stone dusting were 0.2–0.3 J and 100–120 Hz. Limitation of this early experience study is the small sample size. Larger studies are needed to confirm our initial findings.
Conclusions:
Early experience of Moses 2.0 for f-URS renal stone dusting demonstrated effective and efficient laser lithotripsy in patients with renal stones <2 cm.
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