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Purpose <p>To assess differences in dusting and antiretropulsion efficacy between Virtual Basket and Magneto technology pulse modulation in lithotripsy of proximal ureteral stones with the Holmium: YAG laser.</p> Materials and methods <p>Patients with a proximal ureteral stone underwent lithotripsy using the Cyber Ho laser generator (Quanta System<sup>®</sup>). To reduce stone retropulsion and improve dusting efficacy, Virtual Basket (Group A) versus Magneto technology (Group B) was applied. In all cases energy and frequency settings were set at 0.6&#xa0;J and 10&#xa0;Hz respectively. Intraoperative parameters and stone-free rate (SFR) were assessed.</p> Results <p>80 patients were treated (40 in each group). Preoperative features were comparable. Mean stone size was 7.3&#xa0;mm in Group A and 7.9&#xa0;mm in Group B (<i>p</i> = 0.25). In Group A mean operative time was 29.1&#xa0;min, lasing time 5.5&#xa0;min, delivered energy 1.9 KJ and retropulsion occurred in 6 (15.0%) cases. In Group B mean operative time was 25.7&#xa0;min (<i>p</i> = 0.07), lasing time 3.6&#xa0;min (<i>p</i> = 0.05), delivered energy 1.2 KJ (<i>p</i> = 0.06) and retropulsion occurred in 2 (5.0%) cases (<i>p</i> = 0.04). SFR was 92.5% vs. 97.5% (<i>p</i> = 0.06). Intraoperative ureteral lesions were observed in 8 vs. 4 cases (<i>p</i> = 0.05) and no postoperative ureteral strictures occurred.</p> Conclusions <p>The “new” Magneto technology, born as an implementation of the Holmium: YAG Cyber Ho laser generator, showed significant advantages in terms of dusting efficacy and antiretropulsion effect compared to the “old” Virtual Basket pulse modulation in the endoscopic treatment of proximal ureteral stones.</p>

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Old versus new tools to reduce retropulsion of proximal ureteral stones: virtual basket versus Magneto technology pulse modulation, which is the most effective?

  • 期刊论文

  • 发表日期：

    2025年9月20日

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  • Davide Perri,
  • Umberto Besana,
  • Giovanni Balocchi,
  • Giovannalberto Pini,
  • Eugenio Ventimiglia,
  • Javier Romero-Otero,
  • Jean-Baptiste Roche,
  • Dmitry Pushkar,
  • Alexander Govorov,
  • Antonio Luigi Pastore,
  • Ioannis Kartalas Goumas,
  • Laurian Dragos,
  • Giorgio Bozzini

摘要

Purpose

To assess differences in dusting and antiretropulsion efficacy between Virtual Basket and Magneto technology pulse modulation in lithotripsy of proximal ureteral stones with the Holmium: YAG laser.

Materials and methods

Patients with a proximal ureteral stone underwent lithotripsy using the Cyber Ho laser generator (Quanta System®). To reduce stone retropulsion and improve dusting efficacy, Virtual Basket (Group A) versus Magneto technology (Group B) was applied. In all cases energy and frequency settings were set at 0.6 J and 10 Hz respectively. Intraoperative parameters and stone-free rate (SFR) were assessed.

Results

80 patients were treated (40 in each group). Preoperative features were comparable. Mean stone size was 7.3 mm in Group A and 7.9 mm in Group B (p = 0.25). In Group A mean operative time was 29.1 min, lasing time 5.5 min, delivered energy 1.9 KJ and retropulsion occurred in 6 (15.0%) cases. In Group B mean operative time was 25.7 min (p = 0.07), lasing time 3.6 min (p = 0.05), delivered energy 1.2 KJ (p = 0.06) and retropulsion occurred in 2 (5.0%) cases (p = 0.04). SFR was 92.5% vs. 97.5% (p = 0.06). Intraoperative ureteral lesions were observed in 8 vs. 4 cases (p = 0.05) and no postoperative ureteral strictures occurred.

Conclusions

The “new” Magneto technology, born as an implementation of the Holmium: YAG Cyber Ho laser generator, showed significant advantages in terms of dusting efficacy and antiretropulsion effect compared to the “old” Virtual Basket pulse modulation in the endoscopic treatment of proximal ureteral stones.