The Fiber Tow Technique: A Novel Maneuver to Retrieve Ureteric Calculi

Abstract

Introduction

Retrograde stone migration, during ureteroscopic lithotripsy, poses a problem. We describe the fiber tow technique, a novel maneuver to retrieve such stones to facilitate pulverization. The video describes and demonstrates the technique.

Materials and Methods

The technique comprises the following steps:

Step 1: Patient position: Reverse Trendelenberg

Step 2: Ureter distended with irrigation

Step 3: Stop irrigation

Step 4: Pass the laser fiber or lithotripsy probe by the side of the calculus

Step 5: Move circumferentially below the calculus so that the calculus sits on the fiber

Step 6: Withdraw the fiber and scope with the calculus sitting on it.

Repeat as and when required

Pre-tow hydration and diuretic help

Results

Principle:

The calculus cannot slide down the ureteral mucosa because of high inertia of rest. It has to be lifted off the ureteral mucosa—to move it down the ureter. The technique prevents the repeated exchange of stone retrieval devices, reduces cost of the accessories, and saves time, as the same fiber is used for the tow as well as pulverization. It is easily reproducible and can be used in any part of the ureter.

Video description:

The video demonstrates the use of this technique in detail.

Conclusions

The fiber tow allows fast and safe manipulations of calculi during ureteroscopy. It is cost effective, saves time, is easily reproducible, and can be used for any ureteric stone.

No competing financial interests exist.

Runtime of video: 6 mins 11 secs